My Periods Are Very Heavy. Should I Be Concerned?

>> Wednesday, July 17, 2013

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If your menstrual blood varies in color and consistency throughout your monthly period, it's likely that it's perfectly normal. There are times, however, when changes in color, thickness, or clotting may indicate a problem.

During your menstrual cycle, the lining of your uterus thickens to get ready for pregnancy. Then, if you do not become pregnant, your body sheds the uterine lining - causing the bleeding. The amount of blood and fluid lost is usually between 4 and 12 teaspoons each cycle. The average menstrual cycle lasts 28 days, but cycles can be as short as 21 days or as long as 35 days. A normal period lasts between two and seven days.

Many women have clots in their menstrual blood from time to time and the clots may be bright red or dark in color. Often, these clots are shed on the heaviest days of bleeding. The presence of multiple clots in your flow may make your menstrual blood seem thick or denser than usual. If you have excessive clotting or clots larger than a quarter, you should let your doctor know, to rule out any conditions that might be causing an abnormal period.

Sometimes you may notice that your menstrual blood becomes dark brown or almost black as you near the end of your period. This is a normal color change. I t happens when the blood is older and not being expelled from the body quickly.

On a short-term basis, thick, heavy flow isn't necessarily cause for concern. But many women become accustomed to heavy periods, considering them to be normal. Then, over time, excess monthly blood loss leads to anemia, and can potentially cause weakness or fatigue. If you ever feel something is not right with your period, it's important to see your doctor.

Changes in the color and thickness of menstrual blood are often normal. But there are a number of problems that might cause abnormal clots to form in your menstrual blood or lead to changes in color or thickness during your period.

There are many things that could be the cause of your heavy bleeding and it is important to get into your doctor and get tests taken. Irregular, late and heavy periods can be a sign of miscarriage. You may pass blood clots or gray clumps of tissue from the vagina. Miscarriage can cause severely heavy bleeding and this can lead to anemia.

Uterine fibroids (also called leiomyomas) are noncancerous tumors that form in the uterus. Fibroids do not always cause symptoms. But, women with fibroids may have greater than normal amounts of menstrual blood. If you have fibroids, you may have more clots in your period than you had in the past. Another possible cause of irregular, heavy cycles is sudden or gradual hormone changes in the body. Your body relies on a delicate balance of progesterone and estrogen. These hormones regulate the production and shedding of the uterine lining. When this balance is disturbed, it can lead to the development of an excessively thick uterine lining. This thickness can contribute to more bleeding than usual. It can also cause clots in the menstrual blood when the lining is shed.

Also, dramatic weight changes can cause hormone imbalance and cause problems with abnormally heavy menstrual cycles. So can side effects from medications like steroids and antibiotics. Adenomyosis or endometriosis are also common causes of heavy and painful menstrual cycles. These related conditions occur when the tissue that forms the uterine lining is found in the wrong place. In endometriosis, this tissue implants itself outside the uterus by what is called retrograde menses. That is where the blood flow out through the fallopian tubes and the endometrial lining in the blood implants itself on the ovaries, bladder, uterus and even in the lungs. Adenomyosis is where the uterine lining grows into the uterine wall, causing the uterus to enlarge and become boggy. Like endometriosis, this can cause exceptionally heavy menstrual cycles and severe cramps. Endometriosis is more common in younger women, and Adenomyosis is seen more often in older women.

Depending on your symptoms, your doctor may order a variety of tests to determine the reason for all of the bleeding problems. These may include a vaginal ultrasound - which can see Uterine fibroids and measure the size of the uterus. Also, lab work may be ordered to check your blood for anemia, clotting/bleeding disorders or hormone imbalance.

Another test is done in the operating room which allows your doctor to get a biopsy of your uterine lining for pathological analysis. This also allows your doctor to look inside your uterus with a hysteroscopic camera.

Symptoms to watch out for (as they can be a sign that your bleeding problems are worsening) are: fatigue with normal activity, lightheadedness, pale complexion, ashen skin, fingernail beds that are pale, not pink, irregular periods, or frequent bleeding between periods. Anemia can be diagnosed with a simple blood test. Iron supplements result in improvement in most women.

It's important to see your doctor for bleeding problems, as they can lead to severe anemia and other issues that are not worth sacrificing your health for.

Please have a wonderful week, and stay safe while having fun.

Dr. Susan Boyd, MD
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