For about 14 percent of women though, the onset of a menstrual cycle is no laughing matter. These women have a condition called menorrhagia, a very heavy, flooding, or abnormal period (e.g., passing large blood clots). For these women, their monthly friend is more than just an annoyance; it interferes with daily routines, forcing sufferers to stay near restrooms to avoid unwanted leaks.
What is Menorrhagia?
Menorrhagia is the medical term for abnormally heavy or abnormally long bleeding. This condition is quite common in premenopausal women; up to 14 percent of the general population may also suffer from it.
So What’s “Normal”?
According to The Centre for Menstrual Cycle and Ovulation Research, studies show that the most common amount of menstrual flow was about two tablespoons over the course of a five-to-seven day period. However, in the study cited – where laboratory workers collected all tampons and pads and measured flow – the range was wide. Participants ranged from one spot on a pad to over two cups of blood flow in one period!
In general, women who are taller, who have had children, or who are getting close to menopause – a period called perimenopause – have the heaviest flow periods.
How Can I Tell How Much I’m Passing?
As a general rule of thumb, one soaked, normal-sized tampon or pad can hold one teaspoon, or 5 ml, or menstrual fluid. This means that it’s statistically normal for women to soak one to seven normal-sized pads or tampons during one period.
For clinical purposes, soaking more than 16 pads or tampons, or losing more than 80 ml of menstrual fluid, is considered menorrhagia. Unfortunately, women become at risk for developing secondary conditions as a result of menorrhagia if they soak between 9 and 12 regular-sized sanitary products during the course of one menstrual cycle.
Women with this condition are often at risk for developing a low blood count, otherwise called anemia, or may suffer from iron deficiency, because the body is unable to create new blood to compensate for the blood that’s lost during menses.
What Can I Do About It?
Luckily, there are several options to manage this condition, which vary widely depending on a woman’s age and childbearing plans. Among the options you can discuss with your doctor:
Ibuprofen
Taking 200 mg of ibuprofen every 4 – 6 hours during heavy flow periods has been shown to decrease bleeding by 25 to 30 percent, and has the added benefit of reducing the severity of menstrual cramps.
Compensate For Blood Loss
Women who experience heavy periods often feel extreme fatigue, dizziness, or accelerated heart rate, especially when standing up from a seated or prone position. This is an indication that your blood volume has gotten too low. To ease those symptoms and compensate for the blood loss, you should increase your fluid intake and increase your salt intake – particularly by consuming salty fluids, which can range from vegetable juices to broth-based soups.
You may need 4 – 6 extra cups of fluid a day to compensate for the blood loss. If you begin to feel faint when standing, you should call your doctor or seek emergency medical treatment to rule out a complication that may be causing your heavy flow, especially if you don’t typically have heavy periods.
Add Iron
Iron deficiency and anemia are common problems for women who experience heavy flow periods. If you are someone who regularly has heavy periods, or if you’re entering perimenopause, you should add an over the counter (OTC) iron supplement to your daily supplement regimen. You can also increase your intake of iron-rich foods, such as red meat, eggs, and dark green vegetables (like kale and spinach). You should have your blood count tested during your next physical or make an appointment to talk to your doctor about your risks for anemia and/or iron deficiency. It can take up to a year of supplementing to bring your iron levels back up to a safe level, and your doctor can talk to you about diet and supplement needs based on your blood count and bone marrow iron reserves.
Ice Your Abdomen
If your flow is particularly heavy, you may find relief by placing ice packs on your abdomen for 20 minutes intervals several times a day to slow the blood flow.
If the natural options above aren’t spelling relief, or if your flow is interrupting your ability to work or perform your day-to-day responsibilities, you may want to speak with your doctor about prescription treatments that can help lower your blood loss. Among them:
Oral Contraception
The pill is prescribed for more than just birth control. Taking an oral contraceptive can cut your menstrual bleeding by up to 60 percent. How does it to this? By preventing your body from ovulating, the endometrium, or layer that forms and is shed monthly through menstruation, is thinned significantly. Specifically, Natazia is the first birth control pill that was approved by the FDA for use in controlling menorrhagia, when heavy bleeding is not caused by an underlying condition.
Progestin
Progestin hormone treatment can help reduce the effects of estrogen in the body, which can help cut bleeding by up to 15 percent. However, progestin treatment comes with a number of side effects, which range from weight gain and swelling to headaches and depression. These side effects should be discussed with your doctor prior to beginning such a therapy.
Danazol
This form of the testosterone therapy, like progestin, blocks the effects of estrogen on the body, which can stop your period after a six-week period. It comes with its own set of side effects, which include acne and breast size reduction.
IUD
An intrauterine device, or IUD, like Mirena, can help stop heavy menstrual bleeding. This treatment is only recommended for women who already have a child or who are not interested in having more children. Clinical trials have shown that using Mirena can cut menstrual blood loss by more than 50 percent in almost 90 percent of trial participants, through the slow release of a low dose of progestin over an extended period of time.
If you are past your childbearing years, do not want more children, or have other complications, your doctor may have a discussion with you about more radical treatments, such as a hysterectomy, which involves removing the uterus.
If you believe you could be suffering from menorrhagia, consult your physician. There are ways to slow the flow.