Heavy periods are just normal, right?
Heavy menstrual bleeding (HMB) is NOT normal. Being bed-ridden with cramps is not normal. Flooding our clothes, feeling zapped of energy, living with an iron deficiency and experiencing whacky hormonal surges and dips that affect our mood, and consequently our actions and relationships, does not have to be ‘a normal part of being a woman’.
Here, we reveal how heavy periods impact women’s lives, what a normal period is – and what is not normal - along with the latest treatments.
Bye-bye monthly blues!
Heavy periods: The social, emotional and physical impacts
Periods can be the chink in our chain, that’s for sure! For three weeks in the month, everything is fine, then … a chain reaction of negative symptoms. For some women, heavy bleeding and the fear of ‘leaking’ can affect more than just their clothes choices, but also their confidence, their work, their relationships and their social life.
Nicole, 40, knows the score.
“I’ve experienced heavy periods for most of my adult life,” she says. “I actually ask to work from home on my heaviest days, as our work toilet is a ‘shared’ male and female toilet, and in the past the blood has stained the bottom of the toilet bowl. I had to flush the toilet about six times and still couldn’t get rid of it. Now I am too scared to use it.”
There’s other social – or life – disruptors too. Heavy periods are a major cause of anaemia and a host of other issues including fatigue and tiredness, energy depletion, nausea, loose bowel motions, irritability, cramping and blood clots.
Jenny, 43, had just about everything.
“For me the cramping was so bad I’d be bedridden for two days,” she says. “I’d skip the kids’ weekend sports because of the pain, but also because my moods would cranky and low – I’d cry over the stupidest things! And I literally didn’t have the energy to live life like I should have been. I was borderline anaemic for years but my iron would hit record lows during menstruation. It was like ‘life was on hold’.”
Heavy periods: what’s normal?
The textbook menstrual cycle is 28 days. Women bleed, or menstruate from Day 1 to Day 5 inclusive. Then we ovulate on day 14. If the egg is not fertilised, the uterus lining begins the process to shed and bleed and the cycle begins again – bleeding on Day 1 to Day 5.
Blood loss over this period can range from between 20-60 ml (about 4-12 teaspoons).
But this varies greatly, and every woman’s version of ‘normal’ may be slightly different. A more broader sense of a ‘normal period’ is bleeding occurring about every 24-31 days, lasting 4-7 days and losing 20-60 ml (about 4-12 teaspoons) of blood.
Heavy periods: what’s NOT normal?
According to the Australian Commission in Safety and Quality in Health Care (ACSQHC), heavy menstrual bleeding is ‘excessive menstrual blood loss which interferes with the woman’s physical, emotional, social and material quality of life, and which can occur alone or in combination with other symptoms’.1
Additionally, the ACSQHC ‘Heavy Menstrual Bleeding Clinical Care Standard’ guide adds that “periods are a very personal experience and women who have always had heavy periods will often consider this is normal. Symptoms such as flooding through clothing, being unable to leave the house on the heaviest days, and having to change pads and tampons frequently (including at night) are indicative of heavy menstrual bleeding.”
The causes of heavy menstrual bleeding
There are many and sometimes multiple causes of heavy menstrual bleeding. Some of the more common causes include a blood clotting disorder in the endometrium (the lining of the uterus), fibroids, and polyps.
Treatments for heavy menstrual bleeding
Hysterectomy for heavy menstrual bleeding should only be recommended when other less invasive treatments are unsuitable. Uterine-preserving alternatives are recommended for women with benign causes, if clinically appropriate, and include:
- long-acting hormonal intrauterine device (IUD)
- endometrial ablation (a minimally invasive procedure that involves surgical removal of the lining of the uterus) – suitable for women who do not want more children
- removal or destruction of fibroids or polyps using surgical or radiological techniques.
Speak to your doctor who can help you to choose the right treatment option for you. Remember hysterectomy is not necessarily the answer – it is only recommended if less invasive options, such as endometrial ablation, are inappropriate or unsuitable.
For more information about Heavy Periods, treatments and endometrial ablation, visit WearWhiteAgain.com.au