The Curse. The Beast. Aunt Flo (i.e. the weird aunt who makes you cringe). Women, especially young teens just entering their menstruating years, have plenty of pet names for that time of the month. And not surprisingly, most are derogatory. No one really likes getting her period – it’s inconvenient, messy and uncomfortable, at best, and painful or worrisome at worst. For women with heavy and painful periods, the concerns can be serious.

Menorrhagia

Heavy and painful periods can be disruptive to women’s lives. Not only are there significant medical problems associated with this, but the pain and bleeding can cause embarrassing accidents and even missed days at work or school. To help demystify menorrhagia (the medical term for heavy periods), here’s a look at the causes and what can be done to treat it.

Defining ‘Heavy’ Periods

First of all, let’s define “heavy.” If your menstrual bleeding soaks a tampon or pad in an hour, or if you go through eight tampons/pads a day, you are a heavy bleeder. The reason we are concerned about menorrhagia from a medical perspective is that heavy bleeding can lead to iron deficiency or anemia (low blood count) as the body runs through its supply of iron to constantly replace the lost blood cells. Anemia, in turn, can cause fatigue.

Causes of heavy bleeding:

• Fibroids (benign muscle tumors) that make the uterus grow too large and have a large blood supply
• Polyps, often benign outgrowths in the lining of the uterus that bleed heavier than normal lining
• Hormonal abnormalities that cause flow at the wrong times of the cycle
• Uterine cancers and pre-cancers, which is why it is important to get it checked out

Painful periods, including pain from cramps or with intercourse, can be caused by:

• Fibroids
• Endometriosis, which is when the lining cells of the uterus get spread around a women’s pelvis often on the tubes, ovaries, bladder and behind the uterus
• Adenomyosis, which is when the endometrial cells go between the muscle fibers of the uterus

Treatment

Treatment of these conditions depends on what is causing the heavy bleeding or pain. Often, hormonal therapy and treatments can help reduce and control bleeding. This can include starting or adjusting dosing of birth control pills such as Nexplanon and Depo. Mirena IUDs are also often helpful in decreasing bleeding. Some women need surgical treatment to address the cause of pain or heavy bleeding, such as removing polyps (polypectomy), removing fibroids (myomectomy) or even removing the uterus (hysterectomy).

The bottom line is that heavy and/or painful periods are not just an inevitable part of “the curse” that you have to suffer through. If you are experiencing heavy bleeding and/or painful periods, it’s best to see your gynecologist who can help pinpoint the cause and to determine the best course of treatment.

Click here to find a Roper St. Francis gynecologist or OB/GYN near you.

Written by Eleanor Oakman, MD, OB/GYN with Roper St. Francis Physician Partners