The Period Problem series: Heavy periods

Do you experience heavy periods? 

I’m here to tell you friend, the ideal period is a blood loss of 50mL. If you are losing more than this, or more than 80mL/more than 2.5 tablespoons of blood over your menstrual bleed, you have heavy periods!

What does this actually look like? You have heavy periods if you:

  • Are fully soaking more than 10 regular tampons/pads or more than 5 super tampons/pads across your menstrual bleed

  • Need to change pads or tampons during the night

  • Need to change menstrual products every hour or two for several hours in a row

  • Need to double up on pads and tampons to control your menstrual flow

  • Period lasts longer than 7 days

  • Are passing clots larger than a 5 cent piece 

If this is you, we need to investigate! Causes of heavy periods can include: 

  • Cycles where we don’t ovulate (anovulatory cycles) or in high oestrogen conditions - this means oestrogen, unopposed by progesterone, continues to thicken the uterine lining, causing heavy bleeds. This also occurs in perimenopause.  

  • Using the copper IUD, because copper  can increase oestrogen, lower progesterone and lower thyroid function 

  • Thyroid disease or hypothyroidism, which can: 

    • Stimulate prolactin and suppresses ovulation

    • Impair healthy metabolism of oestrogen

    • Rob ovaries of cellular energy need to ovulate, so causes anovulation and low progesterone 

    • Decreases coagulation factors, causing heavy bleeding 

  • Coagulation disorders, where blood doesn’t clot properly (e.g. von willebrand's disease) 

  • Endometriosis and adenomyosis, due to the higher levels of inflammation and infiltration in these diseases, also often (but not always!) higher oestrogen levels

  • Pelvic inflammatory disease due to infection and subsequent inflammation 

  • High histamine, which increases oestrogen, which thickens uterine lining. Mast cells are also found in the uterine lining, and mast cells release both histamine and heparin, which is blood thinner causing heavier periods and increasing blood flow. 

  • Fibroids, or abnormal growths in the uterus

If you have heavy periods, book in for a chat. Life is too short to have sucky heavy periods!

Hayley Brass