Menstrual Flow Heavy
WHEN TO SEE YOUR DOCTOR
* Your periods are so heavy that they interfere with your lifestyle or regular activities.
* You are passing clots and never have before.
* You feel weak or dizzy during your period.
* Your heavy periods are not preceded by your usual premenstrual symptoms, such as breast tenderness, abdominal bloating or food cravings.
* You are also experiencing bleeding between periods.
* Your periods are also more than 45 to 50 days apart.
What Your Symptom Is Telling You
What does "heavy" mean? Well, what is heavy to you might feel normal to Judy down the block. But doctors say that needing to change your pad or tampon more than once an hour is a reasonable measure of heavy.
Overzealous dieting or exercising may cause unusually heavy periods, says Charles Debrovner, M.D., professor of obstetrics and gynecology at New York University School of Medicine in New York City and a gynecologist at New York University Hospital.
Other possible causes of heavy bleeding include infections, clotting problems and polyps or fibroids (benign growths in the uterus).
Symptom Relief
If heavy periods are not the norm for you, see your doctor for diagnosis and treatment. But these tips may help in the meantime.
Lighten up. Scaling back on your busy schedule may help lessen the flow, says Dr. Debrovner.
See it out with C. One simple remedy for a very heavy flow is to take higher doses of vitamin C, says Dr. Debrovner. Vitamin C firms up the walls of tiny blood vessels in the uterus called capillaries and helps decrease monthly blood flow, he explains. He recommends a dose of between 1,000 and 2,000 milligrams daily, beginning a few days before your period and continuing until it ends. (Get the go-ahead from your doctor before taking any supplements.)
Pump up your nutrients. "Make sure your diet includes plenty of B vitamins and iron," says Wulf Utian, M.D., Ph.D., chairman of the Department of Reproductive Biology at Case Western Reserve University in Cleveland. Vitamin B12 and folate are important nutrients for building healthy blood volume and blood quality. "Iron is needed for hemoglobin, another important blood component," he says. The level of B vitamins and iron in a typical daily multiple vitamin should be sufficient.
Help from Your Doctor
When uterine growths or undetermined causes result in heavy periods, your doctor can help with medication, or in some cases, surgery.
Reach for anti-inflammatories. Prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs) may often correct the problem when no specific cause has been found, says Susan Haas, M.D., a reproductive endocrinologist and assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. Your doctor is most likely to prescribe mefenamic acid, which you take up to three times daily during your period, she says. Although ibuprofen is an over-the-counter drug of the same type as Ponstel, Dr. Haas notes, it has not been proven as a treatment for heavy menstrual bleeding.
Avert anemia. In some women, extremely heavy periods may cause several days of mild anemia, says Dr. Utian. In this instance, your doctor may prescribe birth control pills to regularize and lessen the flow. Why the pill for heavy periods? During the first half of the menstrual cycle, the ovaries produce only estrogen, which causes the uterine lining to grow very thick and bleed more when it is shed during a period. When birth control pills containing both estrogen and progesterone are taken, the lining grows less thick, producing less bleeding.
Have the growths removed. If you are diagnosed with polyps or fibroids, your doctor may recommend surgery to remove them. Depending on the size and location of the growths, either abdominal surgery or a newer procedure called hysteroscopy may be needed. During hysteroscopy, a fiber-optic device with tiny surgical instruments attached is passed through the cervix to remove the growths, says Dr. Haas. Seventy-five percent of women who have this procedure are permanently helped, Dr. Haas says.
Another procedure, called endometrial ablation, coagulates the entire uterine lining. Fifty to 80 percent of women with heavy bleeding experience no bleeding at all after this procedure, says Dr. Haas.
Before either of these surgeries, your doctor will prescribe drugs called GnRH agonists for a few months to shrink any growths and cause your periods to stop, Dr. Haas says. "They are used as a short-term fix to allow your body to build blood cells back up before surgery," she says.
