Woman resting at home while dealing with the causes of heavy periods

What Causes Heavy Periods? 8 Possible Reasons

Heavy periods can be difficult to understand, particularly when your bleeding seems to have changed or is affecting your everyday life. Every woman's period is different, but very heavy or unpredictable bleeding is something that deserves attention.

According to Dr Marilyn Glenville PhD in Understanding Heavy Periods (Menorrhagia), there can be several possible reasons for heavy menstrual bleeding. In some women, there may be no obvious gynaecological cause, while in others, heavy bleeding may be linked to an underlying condition or hormonal factor.

Here are eight possible reasons for heavy periods.

The eight possible causes

1. Dysfunctional bleeding

Heavy periods may sometimes have no obvious cause, described as "dysfunctional bleeding". This means that there is no identified gynaecological problem, but the amount of bleeding is greater than expected. The womb lining may build up more than necessary and therefore more needs to be shed during the period. The womb also functions as a muscle, and poor tone may contribute to heavier bleeding.

2. Hormonal imbalance

Excess oestrogen can cause the womb lining to build up too much, resulting in more blood being shed during a period. Excess oestrogen may occur when ovulation does not take place, because progesterone is not available to balance the oestrogen. This is one of the hormonal factors considered when investigating heavy menstrual bleeding.

3. A prostaglandin imbalance

Prostaglandins are hormone-like substances involved in blood clotting, and an imbalance is another possible factor in heavy bleeding. This is also why essential fatty acids and dietary changes form part of a natural approach, since certain types of prostaglandins influence blood flow and clotting. Our article on period pain and prostaglandins explains this mechanism fully.

4. Stress

Stress can potentially contribute to heavy bleeding. If stress is thought to be relevant to your menstrual pattern, it should be addressed as part of looking at the possible factors behind heavy periods. Because heavy periods can have different causes, it's important not to assume that stress is responsible without first having excessive bleeding properly investigated.

5. Fibroids

Fibroids are another possible reason for heavy periods. Women with heavy bleeding may be diagnosed with fibroids, and if heavy bleeding is persistent or particularly severe, identifying whether fibroids or another underlying issue is present is an important part of medical investigation.

6. Polyps

Polyps are non-cancerous growths in the womb. They are fragile structures that can bleed easily. This is one reason why determining the cause of heavy bleeding is important, since what appears to be a change in your normal period may sometimes have an underlying explanation that needs investigating.

7. Pelvic inflammatory disease or another infection

Pelvic inflammatory disease (PID) and other infections of the reproductive tract are among the possible causes of heavy periods. When excessive bleeding occurs, a doctor may consider whether an infection could be involved, and an infection screen using swabs may be included among the investigations carried out.

8. Problems affecting the womb lining

Problems involving the endometrium, or lining of the womb, can also be associated with heavy periods, including endometriosis and endometrial hyperplasia, which is an overgrowth of the womb lining. More rarely, endometrial cancer can be associated with heavy bleeding. This is why it's so important to have excessive bleeding medically investigated rather than simply assuming it's a normal variation of your menstrual cycle.

Other possible factors

The eight factors above are not the only possibilities. Others include hypothyroidism and other hormonal imbalances, problems involving the blood such as anaemia, and certain contraceptive devices, including an IUD and some injectable contraceptives. This range of possible causes shows why there is no single explanation for heavy periods.

Why is it important to investigate heavy periods?

Cases of excessive bleeding should be diagnosed by a doctor, who may refer you to a gynaecologist. Getting a diagnosis is important even if you otherwise feel healthy. Investigations may include an ultrasound scan, a hysteroscopy, blood tests for thyroid function, blood-clotting disorders and anaemia, and an infection screen.

For some women, tests may find a specific reason for the bleeding. For others, there may be no obvious cause. This process of elimination is still important because it helps establish whether there is an underlying problem that needs attention. Our companion guide covers what counts as heavy and when to see a GP.

When heavy bleeding is affecting your life

Heavy periods are not simply about the amount of blood lost. Women describe frequent changes of sanitary protection, leakage during the night, flooding and large clots. For some women, bleeding becomes so unpredictable and intense that everyday activities begin to revolve around their period. If your period is affecting your quality of life or your ability to work, it's important to address it rather than simply putting up with it.

Nutritional support after investigation

Once an underlying condition has been ruled out, nutritional support may be worth discussing with your practitioner, particularly around the prostaglandin balance that influences clotting and womb contractions. Healthy Woman Support provides a broad foundation for women's hormonal health, while Omega 3 Support supplies the essential fatty acids involved in prostaglandin production. Iron should always be tested before supplementing.

The first step: find the reason

There are several possible reasons for heavy periods, from hormonal factors and stress to fibroids, polyps, infections and problems affecting the womb lining. The key message is that the cause should be investigated before beginning a natural treatment programme or taking medication specifically to control the bleeding.

Understanding what may be behind heavy bleeding can help you and your qualified health practitioner decide what should happen next. If you are experiencing excessive bleeding, speak to your doctor and ask about appropriate investigation.

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This article is for information only and is not intended to be a substitute for medical advice. Always consult a qualified doctor or health practitioner before making changes to your diet or supplement routine.

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