How to get relief for heavy periods

Heavy periods can distract from and interrupt day-to-day life. They are defined as periods that last longer than seven days or require tampons or pads to be changed after just two hours. While an occasional heavy period may not be a problem, when menstruation is always heavy or prolonged, it may be a sign of a condition called heavy menstruation. Healthcare providers (HCPs) used to call it menorrhagia.

Heavy menstruation is not usually dangerous. But in rare cases it can be. If left untreated, some people may develop anemia from the blood loss, which can lead to shortness of breath or a higher risk of heart problems. For most women though, heavy menstruation is just irritating—a frustrating impediment to their quality of life.

Either way, there are treatments for persistently heavy periods that can help manage symptoms and even lessen menstrual bleeding.

Causes of heavy menstruation

About one in five women in the United States report heavy menstrual bleeding to an HCP. Certain conditions can contribute to it, including:

• Bleeding disorders
• Noncancerous tumors of the uterus called polyps or fibroids
• Uterine or cervical cancer
• Some types of birth control, such as an intrauterine device (IUD)
• Issues with pregnancy, including miscarriage
• Polyendocrine metabolic ovarian syndrome (PMOS), a condition previously known as polycystic ovary syndrome (PCOS) and other conditions related to hormone imbalances
• Some medications used to prevent blood clots, like aspirin or anticoagulants

Sometimes, even when an HCP performs a variety of diagnostic tests, they may not be able to identify what’s causing the heavy menstruation.

Medications for heavy menstruation

Both over-the-counter and prescription medications may be used to help control the symptoms of menorrhagia. Options include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): When taken during menstruation, these medications may make periods lighter and reduce pain and cramps. Ibuprofen is an NSAID.
• Hormone treatments: To help regulate and lighten periods, an HCP can prescribe birth control pills, progesterone pills, or an intrauterine device (IUD) that releases hormones. Certain hormone treatments may also help thin the lining of the uterus.
• Antifibrinolytics: A prescription antifibrinolytic called tranexamic acid may help make periods lighter.
• Desmopressin nasal spray: For people with bleeding disorders, this medicated nasal spray helps the blood to clot.

Iron supplements are also commonly used to address anemia related to menstrual bleeding.

Medical procedures to treat heavy menstruation

The aim of most medical procedures to ease heavy menstruation is reducing or removing the endometrium, the tissue that lines the uterus and produces menstrual blood. Keep in mind that these procedures are not ideal for people who still wish to have children.

Ablation

In this procedure, a layer of the uterine lining is destroyed through heat, cold, electricity, radio waves, or microwave energy. It can be done on an outpatient basis, and it doesn’t involve making incisions (cuts). About 90 percent of women experience lighter periods or no periods after receiving endometrial ablation, according to the American Society for Reproductive Medicine. It may take a few months for full results to be evident. Heavy periods could return after several years.

Dilation and curettage (D&C)

For this procedure, an HCP scrapes away the internal lining of the uterus. It’s recommended only for emergency situations in which there is acute, heavy bleeding. If you do undergo a D&C, you will need follow-up care and may need a repeat procedure, depending on the severity of your condition.

Hysterectomy

This is the only procedure that stops menstruation permanently in women of reproductive age. It involves surgically removing the uterus. A total hysterectomy removes both the uterus and the cervix, while a partial hysterectomy removes just the uterus. A radical hysterectomy, usually carried out to treat cancer, removes the uterus, cervix, and part of the vagina.

If uterine fibroids are causing the heavy periods, HCP recommendations may differ. Depending on the location and size of the fibroids and whether a woman still desires future pregnancy, there are medical options for treatment, as well as surgical options. These include surgery to remove the fibroids or surgery to cut off the blood supply to them.

Choosing the best approach for you

You and your HCP will have to consider a number of factors when choosing the right treatment for your heavy periods. These include the cause of your symptoms, your age and health, how much your symptoms affect daily life, and how comfortable you are with the treatment options compared to your prognosis with no treatment. Make an appointment with your HCP to discuss your options.