Why are my periods heavy?

Question: I have been bleeding heavily during my menstrual periods for the past couple of months. I am very concerned to what might be the cause of this but I am also too shy to present my problem to my doctor. Could you please point me towards possible causes?

Answer: While we would recommend that you visit your gynaecologist as soon as possible, we did a bit of research on heavy bleeding and some of the causes.

The easiest way to know if you are experiencing heavy periods is to take note of how often you need to change your pad or tampon. If your period is heavy enough to require changing more often than every one or two hours, or if you have a period that lasts more than a full week, you may be experiencing menorrhagia.

Let’s take a look at the most common causes of menorrhagia or heavy menstrual bleeding:

1. A hormonal imbalance during adolescence or menopause is the most common cause of heavy menstrual bleeding. During adolescence, after girls have their first periods and for several years before the onset of menopause when menstruation ceases, our hormones levels are fluctuating which often leads to excessive uterine bleeding during our periods. It’s often possible to treat menorrhagia caused by hormonal imbalances with birth control pills or other hormones.

2. Uterine fibroid tumours are another very common cause of excessive menstruation. It’s important to understand that fibroid tumours are usually benign (non-cancerous) tumours that often occur in the uterus of women during their thirties or forties. While the cause of uterine fibroid tumours is unclear, it is clear that they are estrogen-dependent. Several surgical treatments are available for treating fibroid tumours of the uterus including myomectomy, endometrial ablation, uterine artery embalisation and uterine balloon therapy, as well as hysterectomy. Non-surgical pharmacological treatments for fibroid tumours include GnRH agonists, oral contraceptives, androgens, RU486 (the abortion pill), and gestrinone. Some women find natural progesterone to be an effective treatment for uterine fibroid tumours. Often, when symptoms are not severe or troublesome, a “wait and see” approach is taken. Once menopause occurs, uterine fibroid tumours typically shrink and disappear without treatment.

3. Cervical polyps are small, fragile growths that begin in either the mucosal surface of the cervix, or the endocervical canal and protrude through the opening of the cervix. The cause of cervical polyps is not clear; however, they are often the result of an infection and many times associated with an abnormal response to increased estrogen levels or congestion of the blood vessels located in the cervix. Women most commonly affected by cervical polyps are those over the age of twenty who have had children.

4. Endometrial polyps are typically non-cancerous, growths that protrude from the lining of the uterus. The cause of endometrial polyps is unclear, although they are often associated with an excess of estrogen following hormone treatment or some types of ovarian tumours.