Ask Dr. Crystal Strickland
Get your questions about heavy periods answered by Dr. Strickland! Please select a category to see a list of corresponding questions and answers.
- Not sure if your period is heavy?
- If you have heavy periods, what next?
- Questions about your treatment options?
Not sure if your period is heavy?
Q: How do I know if my period is a heavy period?
A: I see patients in the office every day with heavy menstrual bleeding. I have found that women tend to underestimate their symptoms in regards to bleeding. Common complaints of patients with heavy bleeding include: changing pads/ tampons every one to two hours, passing blood clots larger than a dime, and/or needing to wear more than one sanitary product to prevent an "accident". Avoidance of activities and missing work because of your period are often clues that your period is heavy.
Q: What if my period is extremely heavy some months and regular others?
A: Erratic cycles that vary in flow from month to month are very common especially as women approach their menopausal years. Heavy bleeding is not considered normal even if it does not occur every month. Your period being unpredictable might be a sign that your ovaries are not producing an egg regularly and needs evaluation by a health professional.
If you have heavy periods, what next?
Q: What should I do if I think my period is heavy?
A: The first step after you are concerned about heavy bleeding is to log your cycles. Keep a diary of the number of days, interval, and heaviness of flow on a calendar. A normal period is seven days or less and usually happens every 21 to 35 days. If your flow is extremely heavy or does not follow the typical pattern described above, you should be seen by a doctor for evaluation. Bring your diary to your visit so that your doctor can understand your problem completely.
Q: If I think I have heavy periods, what can I do about it?
A: Many women avoid seeking medical attention because they think the only solutions available require major surgical intervention. Fortunately, there are a variety of conservative options available to treat heavy bleeding. For example, you can try medications or a procedure in your doctor's office that can help. These options don't require you to take significant time off. You don't have to have a highly-invasive procedure, such as a hysterectomy.
Q: What could be causing my heavy periods?
A: There are multiple causes of heavy periods. Most are not serious and can be easily treated. However, it is recommended to see a doctor for evaluation of heavy bleeding because it can be a sign of precancerous/ cancerous conditions. Common reasons for heavy periods include: fibroids, polyps, thyroid problems, infections, menopausal transition, and/or problems with ovulation.
Questions about your treatment options?
Q: Can non-hormonal drugs (NSAIDs/Lysteda®) help lighten my period?
A: Yes these non-hormonal options can reduce pain and bleeding in some patients and are cost-effective. However, you will need to remember to take pills several times per day during your period. Consult with your doctor to see if you are a candidate.
Q: What should I be asking my doctor concerning the treatment for my heavy period?
A: You should ask about the results of your tests and evaluation. Specifically: tests for anemia (low iron because of bleeding) and thyroid. Also, you should always try a minimally-invasive therapy initially, if possible.
Q: What happens if I have an endometrial ablation versus a hysterectomy?
A: Endometrial ablation is a procedure that removes the lining of the uterus that produces blood. The decrease in endometrial lining leads to a lighter period; however, for a large portion of patients their menstrual cycle stops completely post-ablation. This is a conservative procedure with minimal downtime.
A hysterectomy is a surgery that removes the uterus. Some involve an abdominal incision and others can be done laparoscopically which is less invasive. The decision depends on your medical and surgical history and is made by your doctor. The recovery time involved varies depending on the method used and your lifestyle.
Q: What are the negatives of an endometrial ablation?
A: Unfortunately, if you are contemplating pregnancy, you are not an ablation candidate because it removes the uterine lining – an important part of the uterus involved in development of the fetus.
Q: How will I feel after having an endometrial ablation?
A: You can expect cramping that can be managed with oral pain medications. Also, a thin discharge can last up to two weeks. Most people can resume their normal schedule without difficulty post procedure.
Q: What can I expect if I have an endometrial ablation?
A: An ablation usually leads to a lighter period with minimal flow. A large number of patients do not have a period after ablation. The cramping associated with heavy bleeding also tends to resolve and some patients note an improvement in PMS symptoms.
Q: Is there any reason I should not have a hysterectomy?
A: A hysterectomy should be a "last resort" option. It is considered a major surgery and conservative options should be tried first.
The information on the "Ask Dr. Strickland" section of this site is based solely on the experiences and opinions of Dr. Strickland. It is meant to provide general information and is not a substitute for a doctor's visit or professional diagnosis. If you believe you may have any abnormal bleeding, please see your doctor.
To learn more about treatment options, you can download a free brochure and a doctor discussion guide here.