What Causes Heavy Bleeding for Women

Medically Reviewed by Robert L Worthington-Kirsch, MD.

Every woman’s menstrual cycle is unique and often characterized by varying degrees of bleeding. While some experience light flows lasting a few days, others may endure heavier bleeding that disrupts daily life. But what exactly constitutes “heavy bleeding,” and when should it raise concerns?

In this article, we’ll uncover the mysteries behind heavy bleeding for women. From deciphering what’s considered normal to exploring the factors contributing to abnormal bleeding patterns, we’ll share everything you need to know.

What’s a Typical Amount of Bleeding for Women?

Understanding what constitutes a typical amount of bleeding during menstruation is crucial for women who grapple with heavy flows. Generally, the average menstrual cycle involves shedding around 60 milliliters of blood over three to seven days. However, keep in mind that “typical” varies from person to person.

Factors such as age, hormonal fluctuations, and underlying health conditions can all influence menstrual flow. Tracking your cycle and noting any significant changes in bleeding patterns can provide valuable insights into your vascular health.

What Constitutes Heavy Bleeding?

Heavy menstrual bleeding, or menorrhagia, goes beyond the usual amount of blood lost during menstruation and can significantly impact a woman’s quality of life. While there’s no specific volume of blood that universally defines menorrhagia, it’s often characterized by bleeding that lasts longer than seven days or requires frequent changes of sanitary products, such as pads or tampons, within a short timeframe. 

Additionally, passing blood clots larger than a quarter or experiencing symptoms like fatigue, weakness, and severe cramping alongside heavy bleeding may indicate menorrhagia. If your menstrual bleeding disrupts your daily routine or feels unusually excessive, it’s best to consult with a medical professional to determine the cause.

Differentiating Between Normal and Abnormal Bleeding

Distinguishing between normal and abnormal bleeding patterns can be challenging, but there are key indicators to look for. Normal menstrual bleeding typically follows a consistent pattern, lasting three to seven days and gradually tapering off. 

In contrast, abnormal bleeding may involve irregular cycles, excessively heavy flow, bleeding between periods, or bleeding after menopause. Monitoring your menstrual cycle and noting any deviations from your typical pattern can help identify abnormal bleeding.

Common Heavy Bleeding Causes

Heavy menstrual bleeding can stem from various underlying factors, each with its own implications for vascular health. Let’s explore some of the most common causes of heavy bleeding for women. 

Uterine Fibroids

Uterine fibroids are noncancerous growths that develop in or on the uterus, varying in size from small, seed-like nodules to large masses. These fibroids can distort the uterine cavity or put pressure on blood vessels, leading to heavier menstrual bleeding. Additionally, fibroids can cause prolonged periods, pelvic pain, and pressure symptoms.

Endometriosis

Endometriosis occurs when tissue similar to the lining of the uterus grows outside of it, often on the ovaries, fallopian tubes, or other pelvic structures. During menstruation, this tissue bleeds just like the lining of the uterus, leading to heavy bleeding, severe menstrual cramps, and sometimes infertility. The inflammation caused by endometriosis can further exacerbate heavy bleeding and pain during menstruation.

Adenomyosis

Adenomyosis involves the abnormal growth of the endometrial tissue into the muscular wall of the uterus. This condition results in a thickened uterus and can lead to heavy menstrual bleeding, prolonged periods, and severe cramping. The enlarged uterus from adenomyosis can also cause pressure symptoms such as pelvic pain and discomfort.

Hormonal Imbalance

Hormonal imbalances, such as those seen in polycystic ovary syndrome (PCOS) and thyroid disorders, can disrupt the menstrual cycle. Estrogen and progesterone play crucial roles in regulating the menstrual cycle, and irregularities in their levels can lead to heavy or irregular periods. PCOS, for example, is characterized by high levels of androgens and insulin resistance, which can disrupt ovulation and lead to irregular periods with heavy bleeding

Pelvic Inflammatory Disease (PID)

PID is an infection of the female reproductive organs, usually caused by sexually transmitted bacteria like chlamydia or gonorrhea. The infection can cause inflammation and scarring of the reproductive organs, leading to heavy menstrual bleeding, pelvic pain, abnormal vaginal discharge, and fertility issues. PID can also increase the risk of ectopic pregnancy and chronic pelvic pain if left untreated.

Less Common Causes of Heavy Bleeding

While uterine fibroids, endometriosis, and hormonal imbalances are prevalent culprits behind heavy menstrual bleeding, several less common factors can also contribute to this issue. These conditions may not be as frequently encountered but are important to consider when evaluating heavy bleeding.

• Von Willebrand Disease: This inherited bleeding disorder affects the blood’s ability to clot properly, leading to heavy menstrual bleeding, nosebleeds, and prolonged bleeding after minor injuries or surgeries.
• Platelet Disorders: Disorders affecting platelets, such as idiopathic thrombocytopenic purpura (ITP) or thrombocytopathy, can lead to heavy menstrual bleeding due to impaired blood clotting. 
• Endometrial Cancer: This rare form of cancer develops in the lining of the uterus and can lead to heavy or irregular bleeding between periods or after menopause, as well as pelvic pain, weight loss, and abnormal vaginal discharge.
• Cervical Cancer: This cancer originates in the cervix and may cause bleeding after intercourse, between periods, or after menopause. Other symptoms may include pelvic pain and abnormal vaginal discharge.

Remember that these conditions are not common, so experiencing heavy bleeding is not necessarily a major cause for concern. However, if you experience persistent heavy menstrual bleeding or other concerning symptoms, it’s crucial to consult with a healthcare professional for proper evaluation and management.

Diagnosing Heavy Bleeding Disorders

To effectively address heavy bleeding, start by tracking your symptoms and scheduling a consultation with your healthcare provider. Expect a physical examination, including a pelvic exam, to assess for any reproductive organ abnormalities. 

Diagnostic tests such as blood tests, imaging studies, or biopsies may be recommended to pinpoint the cause of your heavy bleeding. Depending on the diagnosis, treatment options may include medication, hormonal therapy, minimally invasive procedures, or surgery. 

Options for Uterine Fibroids Causing Heavy Bleeding

Traditionally, performing a hysterectomy has been considered the go-to solution for uterine fibroids causing heavy bleeding. However, medical advancements have led to a far less invasive alternative: Uterine Fibroid Embolization (UFE). This safe and highly effective procedure involves blocking the blood flow to uterine fibroids, causing them to shrink or resolve, and significantly reducing symptoms. 

Unlike surgery or hormone treatment, UFE preserves the uterus, cervix, and ovaries, ensuring reproductive health. Patients who opt for this same-day outpatient procedure also experience a faster return to daily life compared to surgery, with rapid relief of symptoms and a low rate of complications. 

If you’re seeking relief from the burden of uterine fibroids and heavy bleeding, don’t hesitate to take the next step toward better health. Contact our team to schedule an appointment and explore how Uterine Fibroid Embolization (UFE) can transform your life.

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