Is Heavy Menstrual Bleeding Abnormal?

A heavy period isn’t necessarily an abnormal period. Some women’s menstrual flow can naturally be heavier than others and still be considered normal. Also, an individual woman’s period may change in many different ways (timing, duration, flow, etc.) during the course of her life.

Although heavy periods can be normal, your period should not be so heavy or so painful that it prevents you from performing your normal activities. An abnormal period such as this is described as menorrhagia, a treatable medical condition.

What is a Normal Menstrual Cycle Anyway?

There are many variations that can occur within a normal menstrual cycle and every woman may experience a different “normal.” The first day of menstrual bleeding marks the beginning of the cycle, which can last anywhere from 21 to 45 days, although the average cycle spans about 28 to 30 days. The duration of menstrual bleeding can also vary anywhere from two to seven days, although the average is three to five days.

Menstrual flow refers to the amount of blood that you lose during your period. Some women experience heavier flows than other women, requiring a change of sanitary protection (pads or tampons) every two to four hours. Your flow may also vary during your period; for example, it may be heavier at the beginning, requiring a more frequent change of sanitary protection, than at the end of your period.

Some discomfort due to menstrual cramps is also normal during your period and can be controlled by pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAID) like ibuprofen or naproxen. Applying heat to the abdomen can also be effective.

You may also pass small blood clots during your period. This may initially be alarming, but small clots are considered normal.

Signs of Menorrhagia

Menorrhagia describes a period that is abnormally heavy or prolonged. Women with menorrhagia have a flow so heavy that they need to change out their sanitary protection every hour, and they may experience bleeding that continues for more than a week. Menorrhagia may also cause you to pass abnormally large blood clots.

An abnormal period can cause complications, such as severe pain that interferes with daily activities. You may also lose so much blood that you become anemic, meaning that you have an abnormally low number of red blood cells and your body uses stores of iron to compensate.

There are many potential causes of menorrhagia:

Growths in the uterus; usually benign (harmless) but sometimes malignant (dangerous)
Hormone imbalances
Side effects of certain medications
Genetic bleeding disorders in which clotting is impaired
Gynecologic disorders, such as pelvic inflammatory disease or endometriosis
Other medical conditions, such as kidney or liver disease or thyroid dysfunction

When to See a Doctor

If you experience any of the following signs and symptoms, contact your doctor:

A period lasting longer than 7 days
Needing to change pads or tampons every hour, or having to get up at night to change sanitary protection
Doubling up on your sanitary protection
Passing unusually large blood clots (greater than a quarter in size)
Bleeding in between periods
Any postmenopausal bleeding
Severe pain

Remember that if you are concerned with any change to your menstrual cycle, especially if the change restricts your daily activities, it’s important to discuss it with your doctor.