Are Heavy or Prolonged Periods Disrupting Your Natural Menstrual Cycle?
Menorrhagia and PCOS
Polycystic Ovarian Syndrome is thought to affect upward of 10 percent of all women, which means it is likely to be the root cause of menorrhagia in many cases. PCOS period issues are one of the leading reasons women consult their physicians to seek medical solutions, along with obesity and hypertension-related symptoms.7 It is crucial to correct PCOS-related menorrhagia because the lack of regular periods induced by low levels of progesterone can increase a theoretical risk of endometrial cancer.5 Seeking help is a good course of action for women with PCOS because an influencing factor, Insulin Resistance, is something that can be addressed and action can be taken to reverse its effects.
Amenorrhea is a common symptom of
Polycystic Ovarian Syndrome
What is a Heavy or Prolonged Period?
The correct medical term for a heavy or prolonged period is menorrhagia. It is characterized by severe cyclical bleeding or periods that last longer than seven days. Although some women might think they suffer from this condition, most do not experience blood loss excessive enough to be truly defined as menorrhagia. There are many causes for this condition, and the treatments vary depending on the underlying problem.
The average volume of blood loss during a normal period is usually 40-50 ml. The established definition of a heavy period is when a woman passes more than 80 ml of blood each period for several months.6 Obviously it is not realistic to actually measure the blood flow so most medical practitioners go by a detailed description of a woman’s period instead. Heavy bleeding and some clotting can be common issues for most women at some point in their lives. When this type of excessive flow occurs consecutively for several months it can indicate problems.
Periods are considered to be heavy when:
- A menstrual period that lasts longer than a week
- Large clots are passed
- A period is so heavy it restricts daily activities
- Fatigue, shortness of breath, and tiredness are symptoms
- Soaking through pads or tampons every few hours
- Needing to use multiple methods or double sanitary protection
- Experiencing a sudden onset of bleeding like a tap being turned on
Risk Factors and Causes for Menorrhagia
The causes of menorrhagia can vary widely between women. Age is one of the most important factors doctors look at when trying to discover the underlying cause of this condition. Menorrhagia most commonly occurs in adolescence and in perimenopause when estrogen levels usually exceed progesterone levels. In younger women this type of temporary imbalance often resolves itself over time if there is no underlying condition or pathology.2
In peri menopause approximately one-quarter of women experience at least one or two incidences of extremely heavy menstrual flow, which can be chalked up to higher estrogen and lower progesterone levels. This heavy bleeding is relatively normal for peri menopause, especially between the time of regular menstrual cycles and when periods are skipped at the onset of menopause. However, it is important to keep in mind that age increases the likelihood of underlying disease, as well as uterine fibroids or tumors, so consulting a doctor is not an overreaction to menorrhagia. Any bleeding that occurs after menopause should definitely be looked at by a doctor to rule out serious issues.
In some cases the underlying reason for menorrhagia remains unknown, but some common causes for this condition include:
- Hypothyroidism: ?Hypothyroidism occurs when your thyroid gland is underactive, which means it is under-producing certain hormones. This condition is most likely to be found in women over 50.
- Endometriosis:? Endometriosis is a condition that happens when cells from the lining of the uterus grow in other areas of the body such as the ovaries, bowel, bladder, and rectum. This condition can cause irregular or heavy menstrual cycles, infertility, and pain.
- Hormonal Imbalance:? Hormones obviously play a very important role during the menstrual cycle and a balance between estrogen and progesterone is crucial to control the build-up of the lining of the uterus (endometrium). This lining is shed during menstruation. If the hormones are imbalanced, then this lining will be excessively thick and heavy and clot-filled bleeding will occur instead of a normal flow.
- Anovulation:? This is when ovulation does not occur and as a result progesterone is not produced. This creates an imbalance in hormones and can be the cause of menorrhagia and infertility.
- Fibroids:? Fibroids usually appear in the reproductive years and are benign tumors of the uterus. A natural decrease in progesterone can cause fibroid growth, especially in women between the ages of 40 and 50.
- Polyps:? These are usually benign small growths that can cause abnormal bleeding when they are found on the uterine wall. High hormone levels can often be the basis for polyps, especially in women of reproductive age.
- Adenomyosis: This condition occurs when the endometrial tissue moves into the outer walls of the uterus instead of lining it. The uterus thickens and sometimes a mass can grow in the uterus called an adenomyoma. This condition is most common in middle-aged women who have had children.4
- Hormone (estrogen) Therapy: ? Hormone therapy is used to treat the symptoms of menopause and usually is either estrogen or a combination of estrogen and progesterone. The treatment has certain risks and side effects, which can include abnormal or heavy menstrual bleeding. This irregular bleeding can last up to a year and if it continues longer the doctor will often take a biopsy of the uterine lining to rule out cancer or another condition.
- Intrauterine device (IUD):? Prolonged or heavy periods are a common side effect of using a non-hormonal IUD for birth control. If the flow is excessive or interferes with your daily routine, then you should probably consider removing it and trying another less invasive form of birth control.
- Pregnancy:? Some bleeding can be normal during a pregnancy, especially when it occurs during your scheduled period time frame. However, when bleeding is heavy and happens late or in between your usual period times it might be the sign of a miscarriage or an ectopic pregnancy, which is when the fertilized egg implants in the fallopian tubes instead of the uterus. Both conditions are serious, so contacting your doctor is the best course of action.
- Cancer:? Cancer is not usually the first cause considered for excessive and prolonged menstrual bleeding. It is actually quite rare to find uterine cancer, ovarian cancer, or cervical cancer as the underlying reason for menorrhagia, but since these diseases are serious they should be ruled out after more common causes are exhausted.
- Inherited Disorders:? Conditions that impair blood-clotting factors, such as von Willebrand’s disease, can sometimes cause prolonged excessive menstrual bleeding.2
- Medications:? 7 Certain drugs, such as anti-inflammatory medications or anticoagulants, can cause heavy or prolonged periods. Improper dosage of certain hormone medications also can cause menorrhagia.4
- Pelvic Inflammatory Disease:? PIDisan infection of the uterus, fallopian tubes, and other reproductive organs that can damage the tissues and cause serious consequences such as infertility. It can be a complication of STDs such as gonorrhea and chlamydia.4
- PCOS (Polycystic Ovarian Syndrome):? This condition is also commonly referred to as Chronic Anovulatory Syndrome, Polycystic Ovarian Disease (PCOD), Sclerocystic Ovarian Disease, and Stein-Leventhal Syndrome. PCOS is a hormonal imbalance or disturbance that affects 5-10 percent of women and is the leading cause of infertility. It is characterized by multiple ovarian cysts, weight gain, male pattern baldness, acne, excessive facial or body hair, depression, heavy or completely absent periods, sleep apnea, and thyroid disorders. Basically this condition can affect the entire body and impact mental health as well.
Treatment Options for Menorrhagia
It cannot be overstated how much distress and inconvenience excessive menstrual bleeding can cause for women who live with this condition. Every month the alarming volume of blood and presence of clots is disturbing, and the exhaustion that follows can be debilitating. What is not often understood by others is how this type of bleeding can affect work, vacations, and quality of life. Imagine having to plan life events around specific dates or being house-bound sitting on towels for several days because you cannot go out in public for fear of out-of-control bleeding. When you do leave the house carrying extra pants and undergarments becomes a habit, as well as sitting on the edge of seats. It should not come as a surprise that menorrhagia is the leading reason given for elective hysterectomies. Fortunately there are treatment options other than surgery to provide much needed relief for women suffering from this condition.
Treatment will depend entirely on the underlying cause of the menstrual irregularity, which means some tests might be the first step to establishing a course of action. A pelvic examination is often required, especially for women over 40, along with an ultrasound and perhaps a biopsy to ensure there is no abnormal pathology causing the prolonged and often painful bleeding. If some type of specific diagnosis is made, such as fibroids or PID, then the treatment can address that cause and relieve the symptoms.
The most common therapy used to treat menorrhagia is oral contraceptives, which in theory are supposed to control the bleeding and balance the hormones. Large doses of progesterone are often required to counterbalance excessive estrogen, especially in perimenopausal women. Oral contraceptives work for some women to correct the issue of heavy periods but tend to fail many others after a few months. Side effects from this type of hormone therapy can be unpleasant as well, so unless you require birth control pills to prevent pregnancy another treatment might be recommended.2
Can you treat heavy periods naturally?
In many cases the underlying cause of menorrhagia is hormonal imbalances created by lifestyle choices, diet, and stress.5 This means heavy prolonged periods can often be brought under control with diet and exercise modifications as well as targeted nutritional supplements. PCOS period issues in particular can be improved by addressing Insulin Resistance, making healthy diet choices, and starting an exercise plan. Even a relatively small weight loss can help normalize the menstrual cycle. More pronounced weight losses can significantly impact conditions such as PCOS and help minimize the symptoms of menorrhagia.5
PCOS and a likely Root Cause: Insulin Resistance
What are the root causes of PCOS’s debilitating, variable symptoms such as weight gain, menorrhagia, infertility, acne, baldness, and even trouble with breastfeeding? One answer is Insulin Resistance or IR. The key to improving your health is gaining an understanding of Insulin Resistance and taking action to reverse it.
- Attaran, M. (2010). Polycystic Ovary Syndrome. Retrieved 07 10, 2012, from Cleveland Clinic Center for Continuing Education: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/womens-health/polycystic-ovary-syndrome/
- 2 BARBARA S. APGAR, M. M.-N. (2007, 06 15). Treatment of Menorrhagia. Retrieved 07 10, 2012, from American Family Physican: http://www.aafp.org/afp/2007/0615/p1813.html
- Julia A Shaw, M. M. (2012, 03 15). Menorrhagia Treatment & Management. Retrieved 07 10, 2012, from Medscape Reference: http://emedicine.medscape.com/article/255540-treatment
- Mayo Clinic Staff. (2011, 06 25). Menorrhagia. Retrieved 07 10, 2012, from Mayo Clinic: http://www.mayoclinic.com/health/menorrhagia/DS00394
- Morris, D. R. (2010, 02 23). PCOS. Retrieved 07 10, 2012, from IVFI: http://www.ivf1.com/PCOS/
- Prior, D. J. (2007, 12 06). For Healthcare Providers: Managing Menorrhagia Without Surgery. Retrieved 07 10, 2012, from Centre for Menstrual Cycle and Ovulation Research.
- Robert J Norman, R. W. (2004, 08). Polycystic ovary syndrome. Retrieved 07 10, 2012, from Medical Journal of Australia: https://www.mja.com.au/journal/2004/180/3/4-polycystic-ovary-syndrome
The Insulite PCOS System is not intended to be medical treatment, nor is information on this website intended to be a substitute for the advice or care of a health-care practitioner. The Insulite PCOS System is a combination of nutritional supplementation and lifestyle programs intended to help individuals better manage their health and wellbeing. Consult a health-care practitioner before beginning the Insulite PCOS System. Because of ongoing research, clinical experience, and the rapid accumulation of information relating to the subject matter discussed on this website, the website’s users are advised to carefully review and evaluate the information on this website and continue to expand and broaden their knowledge of new information as it becomes available on this website and elsewhere. The use or application of the information contained on this website is at the sole discretion and risk of the user.
Since June 2008, Insulite Laboratories and Insulite Health has supported more than 2.4 million women through the Insulite PCOS System, through this website, through emails providing information and support, through consultations with our Consulting & Advisory Team, through telephone conference calls, through online webinars, through published articles, and most recently, through social media community building and support efforts. Insulite Laboratories and Insulite Health are singularly dedicated to improving the lives of women with PCOS and conditions resulting from Insulin Resistance.