Heavy Bleeding and Bad Periods: When To See a Doctor About Menstruation Issues Everyday Health MenuNewslettersSearch Endometriosis Should You See a Doctor for a Heavy Period Sometimes heavy menstruation is related to a health problem that requires medical attention. By Meryl Davids LandauMedically Reviewed by Kacy Church, MDReviewed: February 28, 2019Medically ReviewedMenstrual flow may vary, but there are some changes that warrant a call to your doctor.iStock (2)A heavy period is a major annoyance. It can keep you from leaving your house, wearing certain clothing, even sleeping through the night. But is it more than that? Is heavy monthly bleeding a sign of a medical condition that should be evaluated and treated? Heavy Periods What to Consider A heavy menstrual period can indeed be a sign of a health problem, but even if it’s not, the crimp it puts in your lifestyle make it worth fixing, says Amanika Kumar, MD, a gynecologic oncologist at the Mayo Clinic in Rochester, Minnesota. Related: 10 Ways To Relieve Period Cramps What’s more, the more extensive blood loss from a constantly heavy period can lead to iron-deficiency anemia, which itself is a health concern. Intense Monthly Periods Are a Common Occurrence According to the American College of Obstetricians and Gynecologists (ACOG), about one-third of all women complain of heavy bleeding when they see their physician. In medical terms, this condition is known as menorrhagia. Related: The Wild History of Women’s Hormone Therapy In many cases, the heavy bleeding is not caused by illness. Lifestyle issues, such as stress or even travel, can make your period temporarily heavier. Women in their late thirties or forties can also find their period intensifying due to perimenopause, Dr. Kumar says. Related: Endometriosis and Severe Sex Pain: How to Cope Possible Medical Causes of Heavy Menstrual Bleeding Sometimes, though, menorrhagia can be a symptom of a health issue. These include:Fibroids and Polyps These are growths that develop in and around the uterus, affecting blood flow.Adenomyosis and Endometriosis In these conditions, endometrial-like tissue grows outside the places they’re supposed to. With adenomyosis, that tissue makes its way to the thick, muscular layer of the uterus, known as the myometrium. With endometriosis, that tissue leaves the uterus entirely.Irregular Ovulation During puberty or perimenopause, or if you have polycystic ovary syndrome (PCOS) or hypothyroidism, you might not ovulate regularly. This results in the lining of the uterus becoming too thick, so when it sheds, it does so heavily.Certain Medication Aspirin and blood thinners can result in more intensive bleeding. During its first year after insertion, so can a copper intrauterine device (IUD).Cancer Most cases of endometrial cancer are diagnosed in women past menopause, when any bleeding — heavy or not — should be evaluated by your doctor. Still, “younger women often underestimate their risk of endometrial cancer,” Kumar says, since cancerous changes in the lining of the uterus can be mistaken for a typical heavy or painful flow.Other Causes Bleeding disorders, pelvic inflammatory disease (PID), ectopic pregnancy, or miscarriage are other possible causes. Related: Celebrities Who Spoke Out About Their Miscarriages What s Considered a Heavy Period While you may think your period is heavy because it flows fully on the first day, doctors have specific criteria they look for. Soaking through one or more tampon or pad every hour for several hours is a prime gauge. So is needing to change pads in the middle of the night, or having to double up — wearing both a tampon and a pad to catch the overflow. Other factors are bleeding that lasts more than a week, or shedding quarter-size clots along with your period. “Any change in your regular cycle — such as going from changing a pad every three hours to every half hour — should be evaluated,” Kumar says. In most cases, you should track your cycle for a few months, because doctors like to see if the problem persists for two to four periods. To do this, it’s a good idea to keep a period diary for a few months. Related: 7 Celebrities Living With Endometriosis Diagnosis of Menstrual Period–Related Problems The most important issue in a medical evaluation is your personal history, where the doctor will ask about your past and present health conditions, medication you take — especially birth control — and your menstrual history. Your doctor will likely also do a pelvic exam, and possibly take an ultrasound image of your uterus. Hysteroscopy and Other Testing May Be Required Occasionally, more advanced tests are needed, such as hysteroscopy (a lighted scope is inserted for a close-up view), sonohysterography (fluids are added during ultrasound to enhance vision), magnetic resonance imaging (MRI), or an endometrial biopsy (a sample of tissue is removed and examined). Do Birth Control Pills Stop Heavy Bleeding Because they supply a steady hormone dose, birth control pills are often used to regulate a too-heavy flow. With some forms of pills, your period will not merely lessen, it will stop altogether. Oral contraceptives are especially prescribed when the excess bleeding is caused by ovulation issues, PCOS, or fibroids. Another hormonal option is the IUD, which releases a steady flow of hormones directly to the pelvis. This reduces menstrual flow along with providing reliable birth control. Other Treatments for Heavy Menstruation Symptoms Because heavy periods are also thought to sometimes be caused by the body’s reduced production of prostaglandins — especially during perimenopause — nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin (ibuprofen) are often recommended, Kumar says. Your doctor can also prescribe the drug Lysteda (tranexamic acid), which targets a protein that helps blood to clot. This drug comes in a tablet and is taken each month at the start of your menstrual period. Side effects, while rare, can include muscle pain, a runny nose, or, more seriously, unusual bruising or bleeding. If fibroids are the main cause, your doctor may remove them via uterine artery embolism (UAE), which blocks blood flow to the fibroid, causing it to shrivel, or myomectomy, their surgical removal. Uncommon and Drastic Measures Related to Heavy Bleeding For women who no longer plan to have children and have not been helped by these other measures, more extreme approaches are sometimes used. These include endometrial ablation, where the uterine lining is heated and destroyed, or hysterectomy, the surgical removal of the entire uterus. Most Recent in Endometriosis Why Is My Menstrual Period Heavy What to Know About Uterine Fibroid Pain — and How to Find Relief The Link Between Uterine Fibroids and Heavy Menstrual Bleeding What Women of Color Should Know About Uterine FibroidsNEWSLETTERS Sign up for our Women' s Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. 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