Heavy menstrual bleeding - what you need to know

Dealing with heavy menstrual bleeding: tips and treatment

Navigating the ebb and flow of periods can be challenging, especially when it comes to the amount of blood we shed each month. For some of us, menstruation is unremarkable, demanding nothing more than a block of chocolate and a week’s supply of period undies. For others, it’s marked by heavy menstrual bleeding that can drag on for days, leaving pain and exhaustion in its wake.     

So, how much period blood loss is too much? It's a puzzling question, but thankfully we've got the answers. Join us as we delve into heavy periods (aka menorrhagia) and explore how you can manage symptoms and find relief during that time of the month.

 

Let's talk about menorrhagia

Heavy menstrual bleeding, or menorrhagia, refers to bleeding that lasts longer than 7 days and is heavy. But what does heavy look like?

To answer this question, we spoke with Dr Raewyn Teirney, a leading Australian fertility specialist and gynaecologist, who shared that heavy periods involve excess menstrual bleeding beyond what’s considered normal. "Normal bleeding usually lasts up to 7 days, with maximum blood loss of around 70 mls," she says. 

Menorrhagia is characterised by both excess volume and prolonged bleeding. "If you experience heavy bleeding for a duration longer than 7 days, that’s considered abnormal, and we refer to it as menorrhagia."

Menorrhagia is a common condition, affecting around 1 in 5 people who menstruate in Australia. 

 

 

Signs you're losing too much blood during your period

We should expect to shed a maximum of 70 mls of blood with every period, but measuring blood loss is tricky. Sure, you could check your underwear or the toilet bowl, but they’re  unlikely to give you an accurate answer. 

So, what’s the best way to know? The most effective method of measuring blood loss is to monitor how frequently you need to change your period products and whether you experience regular leaks. Dr Raewyn suggests you "shouldn’t be flooding through your clothes, period undies, pads and tampons." 

If you feel like you’re losing too much blood, watch out for these signs:

• Periods that last more than 7 days or irregular periods with heavy bleeding. 
• Experiencing menstrual flow that soaks through 1 or more pads or tampons every hour, in periods throughout the day. 
• Needing to use 2 pads to manage heavy bleeding. 
• Needing to change your pads or tampons overnight. 
• Experiencing constant pain and cramps with bleeding. 
• Dealing with heavy bleeding that interferes with your daily life and planned activities.
• Feeling zapped of energy or becoming short of breath.  
• Passing blood clots bigger than a 10-cent coin.
  

 

 

If you experience heavy periods and clots, take note. 

While it's normal to see blood clots with heavy periods, larger and more frequent clots warrant medical attention. Clots can range in colour and size, but if you notice regular clotting larger than a 10-cent coin, it’s important to consult your doctor or gynaecologist. 

Clots can signal an underlying health condition that requires investigation, including endometriosis, adenomyosis, uterine fibroids, hormone imbalances, miscarriage, or, in some cases, even cancer. Taking prompt action and consulting a healthcare professional can ease your mind and safeguard your wellbeing. 

 

Causes of heavy menstrual bleeding

There are a bunch of reasons why you might experience heavier than usual periods. Some common causes include hormone imbalances, cancerous and non-cancerous growths in the uterus (like fibroids), infections, complications during pregnancy and certain medications. An underlying medical condition, like endometriosis and adenomyosis, can also contribute to heavy periods. 

The above might sound scary, but help (and answers) are on hand. Identifying the cause of heavy bleeding is the first step towards effective management and treatment, so it’s important to consult a healthcare professional for proper evaluation and personalised care.

 

 

Treatment and management of heavy periods

Heavy bleeding with periods can be challenging, but several treatments are available to help you manage and minimise its impact on your daily life.

The first step is to investigate why menstruation is heavier than usual for you. A trained healthcare professional will ask you a series of questions about your period and refer you for tests and scans (like an ultrasound) when necessary.  

Dr Raewyn explains that a full blood count is important when investigating the cause to check for things like anaemia, an underactive or overactive thyroid, pregnancy, and possible miscarriage. 

"We also check all the different hormones in the menstrual cycle like estrogen, progesterone, follicle-stimulating hormone and luteinising hormone because it’s more common to get menorrhagia as people age and edge closer to menopause," she says. 

When investigations are complete, your doctor will create a tailored treatment plan based on your results. Treatments vary from person to person, depending on their situation, but some common options include:

• Using oral contraceptives and other drugs to control heavy bleeding. 
• Hormone therapy or inserting intrauterine devices (IUDs), like the Mirena, to manage menorrhagia. 
• Taking supplements or booking infusions to address a deficiency.
• In some cases, surgery may be necessary to remove fibroids and manage other conditions like endometriosis.  

If you're planning to consult a professional, it can help to keep a cycle diary or use an app like Hello Clue. Both options can help you track your cycle length, flow and symptoms to give your care provider a better picture of what's going on. 

 

Need some leak-proof protection?

Heavy periods are common, but you don’t have to suffer in silence. With the right care and our Maxi Absorbency range of leak-proof period underwear, you can take charge of heavy periods and live your life to the fullest — every day of the month.