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Is Your Period Too Heavy? We have answers for you!

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How much blood is really too much?

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If your period tends to be heavier, you are probably wondering how much blood is actually "too much" menstrual blood. So we asked two gynecologists everything you wanted to know about heavy periods and what you can do about it.

Dr. Mary Jane Minkin, clinical professor of obstetrics, gynecology, and reproductive science at Yale School of Medicine, and Dr. Cindy Basinski given these answers:

1. What exactly is a "normal" period?

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Because every body and period is different, it is difficult to come up with a black and white definition of a "normal" period, Minkin said. Nevertheless, there are a few criteria for a typically healthy period:

• She comes fairly regularly, i. H. about once a month (this can range from 21 days to 35 days).

• It usually lasts about six days or less.

• When you're on your period, you don't need more than one tampon or pad every few hours. Or, if you're using a menstrual cup, you're not bleeding more than about 80 milliliters per period (which you can check based on the size of your cup).

2. So what does it mean, then, to have a heavy period?

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There are two ways you can bleed too much: the actual amount of blood and the number of days you bleed. Medically speaking, the definition of a heavy period is when you bleed more than 80 milliliters over the course of your period, or your period lasts a week or more.

But since you are unlikely to be in the habit of measuring your menstrual blood, you can look for practical signs instead: "If you stain lots of clothes or have to put towels on furniture or bedding to catch blood during your cycle, it is likely you'll bleed more than average during your period, "says Basinski. "If you change your tampon or pad (or empty your menstrual cup) more than every few hours on any day, you are likely to have profuse bleeding."

3. What about the good old blood clots?

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Yes, these most likely also meet the criteria for profuse bleeding: watch out for lumps that are the size of a 50-cent coin or larger, because if you see them, you will likely lose an above-average amount of blood during your cycle, explains Basinski.

4. Okay - but how strong is really "too" strong?

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To be honest, it's totally subjective. Minkin had patients who had fairly normal bleeding but were convinced that it would flow out of them like it did in Niagara Falls, while other patients were actually at waterfall level but didn't care.

So it is too much if it restricts and disturbs you in your everyday life. "For example, you have to go to the bathroom very often because you are afraid of leaving stains all the time," says Basinski. "Or you cancel plans because you have your days and the feeling that you cannot leave the house. Or your sex life and your relationships are disrupted as a result. There is no scientific limit that you have to cross: If it is too strong for YOU then it is too strong.

5. Um, sounds like me! Should I be worried?

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Don't worry, but definitely see your doctor so you can start doing something about it! Heavy menstrual bleeding is common: about a third of women are treated for it, according to the American College of Obstetricians and Gynecologists. And while heavy bleeding can be a sign of a health problem that should be treated, you shouldn't lose your nerve until you know what's going on.

6. Alsooooo: Why do some people have hellish nightmare periods while others get along really well with tampons lite and panty liners?

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In all honesty, the reason for a heavy period is sometimes unknown: Some people just bleed more than others, Minkin says. Still, there are a few things that have been (though not always) associated with heavy menstrual bleeding:

Structural abnormalities such as fibroids and polyps that grow in the uterus. You can find more information about the difference between the two here.

Irregular ovulation caused by puberty and perimenopause or health problems such as polycystic ovarian syndrome or hypothyroidism. Because if you don't ovulate regularly, the lining of the uterus can become very thick. And when you finally get your period? "Then it's a bloodbath," says Minkin.

Endometriosis. Also known as a condition in which the tissue that normally lines the inside of the uterus grows outside the uterus (typically in your ovaries, fallopian tubes, or pelvic organs).

Pelvic inflammatory disease. Also known as an infection of the female genital organs, which is usually (but not always) a complication of an STD.

Bleeding disorders that prevent the blood from clotting properly.

Certain medications such as blood thinners and aspirin.

Endometrial cancer. However, this is rare and is usually diagnosed in women who have passed through menopause - this means that heavy menstrual bleeding is definitely a sign that something is wrong.

That sounds like a lot - thank you, body - but don't fall for Dr. Google in. Your doctor will help you figure out what's really going on.

7. My doctor has told me that my periods are normal. To be honest, it doesn't feel normal. What should I do?

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Most doctors really want to help you. So make sure you have as much information as possible about your symptoms ready at your appointment, advises Basinski. The more precise the information you can give about your menstrual cycle, the better. So it's really helpful to use an app or calendar to track your period and keep track of it. If not, that's okay too. But be prepared to answer questions about your last few cycles, such as how long your cycle lasted, how many days you bleeded, the intensity of the bleeding, etc.

You are also welcome to take notes so that you do not forget anything - both about your questions and information about your menstruation. And please, don't downplay the symptoms. The fact is that sexist clichés can get in the way of a correct diagnosis: Unfortunately, symptoms of women are still taken less seriously than those of men. And women were educated from the start to "endure" pain and symptoms and not consider them so important.

And if you don't have a good experience with your doctor or they just don't fit together well: Get a second opinion and change your practice if necessary. Doctors would like to help you and build good patient loyalty.

8. Is there anything I can do about the heavy bleeding or do I just have to live like that?

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There are tons of things you can do! Heavy bleeding that is affecting your daily life should be treated whether or not you've learned that crappy periods are just something to deal with. Of course, your doctor will be the person who will advise you on the best treatment. But just for your information, here are a few options that can be mentioned:

Hormone treatments such as B. the contraceptive pill, hormone IUDs and hormone injections. "These treatments work well in young women because they can often be reversed and maintain fertility if those women want to have children," says Basinski.

Other drugs that control blood flow. Things like ibuprofen can moderately decrease blood flow, according to Basinski. There are also medications such as tranexamic acid (such as Lysteda) that you take during your period and that help your blood clot.

Surgery to get rid of fibroids and polyps, if you have them.

Uterine fibroid embolization, which is used to treat fibroids. This blocks blood vessels to the uterus so that fibroids cannot grow. Because the doctor uses a catheter to inject embolic agents into the uterine arteries, which cut off the blood supply, this is an alternative for anyone who doesn't want surgery to treat fibroids, explains Minkin.

Endometrial ablation, which is a procedure in which the lining of the uterus is destroyed to stop or reduce menstrual bleeding. Several different endometrial ablation technologies are available, according to Basinski. Most of these take a few minutes and can be done on an outpatient basis, although some doctors also use the operating room. Although this also limits fertility, there are no surgical risks of a hysterectomy here. "You don't take out the whole organ, you just remove the internal function of an organ," says Basinski.

A hysterectomy, i. H. the surgical removal of the uterus. According to Basinski, patients find hysterectomies attractive because they are 100% effective: No uterus, no periods! - and these are usually discussed for more serious cases of abnormal bleeding when other treatment options fail or are not an option.

9. Wonderful! Is there anything else I should know?

We've pretty much covered everything! Again, be very clear: Heavy periods are corrosive and there are always ways to improve your quality of life. So talk to professionals.

Would you like more on the subject?

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This article first appeared in English.