Women who experience irregular or heavy periods should see their doctor to determine the underlying cause. In addition to discussing the symptoms of heavy menstrual bleeding, a doctor will also want to know whether the woman is taking any medications or experiencing other symptoms. After a thorough pelvic exam, a doctor may order diagnostic tests to determine the cause. These tests can include blood tests to determine hormone levels, cultures of tissue samples, and ultrasounds.
Stress
The hormones involved in menstrual bleeding can be affected by stress. Managing stress is important in ensuring your period stays on schedule. There are many natural ways to reduce stress and regulate your menstrual cycle. These include: limiting stress, practicing body intuition, and establishing healthy boundaries. If you experience a prolonged period of missed periods or if your bleeding lasts longer than six weeks, you should consult with a doctor.
The hormone cortisol can interfere with the production of progesterone, which causes irregular periods and spotting. Stress can also cause menstrual cycles to become irregular and heavier. Women who are under a lot of stress have an increased risk of developing amenorrhea, a condition in which they miss one or two menstrual periods.
Immaturity of the hypothalamic-pituitary-ovarian axis
Immaturity of the hypothalamic pituitary-ovarian axis (HPO) is a disorder that affects the production of hormones that control the menstrual cycle. This disorder can lead to abnormal bleeding during a woman’s period. It is often accompanied by anemia and is best managed by medical management.
Heavy menstrual bleeding is common in adolescents, but it may be a symptom of another problem. Heavy menstrual bleeding is often a sign of anovulation. It may be indicative of a bleeding disorder, which is difficult to diagnose without an accurate history and physical examination. Because heavy bleeding can mask other conditions, a diagnosis of a bleeding disorder should be made only after excluding other possibilities.
The hypothalamic-pituitary ovarian axis is a complex axis that functions in concert to regulate various functions necessary for reproduction. The HPO axis produces cyclic hormones that determine which follicles will be fertile and prime the endometrium for implantation. The ovary plays a pivotal role in steroid hormone production and also influences the hormonal environment necessary for oocyte maturation. Pathologies in any of these three junctures can negatively impact this complex regulation.
Nonsteroidal anti-inflammatory drugs
While NSAIDs are often prescribed for severe pain, they have other side effects that can affect overall health and menstrual bleeding. In fact, according to the Cleveland Clinic, NSAIDs can increase the risk of stomach ulcers and kidney problems. This is why it is critical to limit the use of NSAIDs during your menstrual cycle.
Although NSAIDs can cause menstrual bleeding, they are also effective in reducing painful menstrual cramps. However, they are best taken one to two days before your expected bleeding or when the pain begins.
Fertilized eggs not attaching to the uterine wall
Bleeding during pregnancy is a common occurrence for pregnant women. The first few days of pregnancy are called implantation bleeding, and this type of bleeding typically occurs 10-14 days after conception. This light, regular bleeding is caused by the movement of the fertilized egg in the uterus. It is harmless and usually does not require medical treatment. One-third of pregnant women will experience this type of bleeding during pregnancy. It happens during the first couple weeks of pregnancy and does not require medical care.
After fertilization, an egg travels to the uterus where it attaches to the uterine lining and implants itself in the endometrium. The lining of the uterus is covered in blood vessels, and this movement may result in bleeding during the first few days of your menstruation. However, the bleeding during implantation does not cause concern and is usually not more than a week prior to your expected period.
Uterine fibroids
If you are experiencing irregular heavy periods, spotting in between your periods, or blood clots in your flow, you may have fibroids. It’s important to monitor your symptoms and contact a doctor if they continue or worsen. If you’re bleeding excessively, you may need to consider surgical procedures or medications.
Treatment for fibroids varies from woman to woman. Some women may be prescribed low-dose birth control pills to manage heavy bleeding while others may need hormonal injections. There are also surgical procedures such as laparoscopy and surgery, which can remove the fibroids. Although these surgical options can be effective, some women may not be able to undergo them.
Often, fibroids do not cause severe symptoms. But they can interfere with a woman’s daily activities. Heavy menstrual bleeding can make a woman anemic, resulting in low red blood cell counts and fatigue. If these symptoms occur frequently, however, a doctor will want to perform further tests.