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One month your period is light and low-key. The next it’s the bucket scene from “Carrie.”
On average, a woman loses up to 1.5 shot glasses full of blood during a monthly period, along with bits and bobs of lining and clots. It’s totally normal to have some heavier cycles, with or without cramping, but If your period is heavy enough to interrupt your life, that’s another story.
“Menorrhagia” is med-speak for “heavy periods.” It’s normal to change a pad or tampon about every 4 hours. But if you’re soaking through them every 1 to 2 hours, your doctor will consider it menorrhagia-level heavy.
You can take back control of your flow with simple dietary changes, home remedies, rest, and over-the-counter (OTC) pain relievers.
Pump some iron
Your body needs iron to create new blood cells and make hemoglobin, which helps red blood cells carry oxygen. Very heavy periods can cause iron-deficiency anemia, and some research suggests low iron levels can even cause heavier periods.
Be on the lookout for these symptoms of anemia:
- pale skin
- extreme fatigue
If you have anemia or think you might, you can load up on iron by eating these foods:
- lean beef
- oysters and shellfish
- dark leafy greens
- blackstrap molasses
- liver (try it in pâté form)
- pumpkin seeds
- dark chocolate
Talk to your healthcare provider if you’re concerned about low iron levels. They can check your level and recommend an appropriate dose for an iron supplement if necessary.
Cook in cast iron
If you have a cast-iron skillet, you can use it to increase your iron intake. High moisture foods like sauces absorb the most iron.
Remember vitamin C
Vitamin C makes a great sidekick to help your body absorb more iron.
Foods high in vitamin C include:
- tomato juice
- brussels sprouts
- red and green peppers
If you’re struggling to get enough vitamin C in your diet, you can try a supplement.
Light-colored or pale urine indicates that you’re properly hydrated. If you have darker urine, it’s a sign that you need to increase your fluid intake.
Water is the best option for hydration, but if you’re feeling particularly dehydrated during your period, you may want to add electrolyte-rich beverages like coconut water.
This syrupy byproduct of cane sugar is jam-packed with magnesium, calcium, selenium, and iron — all nutrients that need replenishing during a heavy period.
You can find it in grocery stores or online.
Talk to your doctor before using any herbal supplements to address heavy periods. Some herbs can interact with common medications, so it’s best to check with a qualified healthcare provider to ensure safety.
Studies on these herbal options are promising:
Don’t let cramps crash your already-heavy crimson wave. Try an NSAID (nonsteroidal anti-inflammatory drug) like aspirin, naproxen sodium (Aleve), or ibuprofen (Advil).
Research shows NSAIDs can also reduce blood flow by 20 to 40 percent by reducing prostaglandins, hormone-like compounds that disrupt blood clotting.
NSAIDS can be bad for you if not used properly. High doses or long-term use can cause side effects. It’s a good idea to talk to your doctor about a safe dosage.
If your flow has you in a state of increasing woe, chat with your doctor about these options:
Hormonal birth control
Birth control thins the uterine lining, resulting in lighter periods. It can also lessen period symptoms like cramps, mood changes, and headaches.
Some options to consider:
- Hormonal IUD (intrauterine device): A popular birth control device that’s placed inside your uterus to prevent pregnancy and can also reduce heavy periods. The copper IUD isn’t as effective at reducing bleeding since it doesn’t contain hormones.
- Depo shot: A doctor injects Depo-Provera into your arm or booty once every 3 months. It may cause weight gain.
- Pill, patch, or ring: These are generally used for 21 days and then stopped for the 7 days of menstruation. They may come with some side effects like bloating, tender breasts, and spotting between periods.
Aygestin is a pill that contains progestin. Taking a 5-milligram dose three times a day from day 5 to 26 of your period can help reduce very heavy bleeding.
Tranexamic acid (Lysteda)
Lysteda is an antifibrinolytic tablet, which means it prevents your body from breaking down blood clots. Side effects include muscle cramps and headaches. You only need to take it for a few days in the month.
Gonadotropin-releasing hormone (GnRH) agonists
These meds are available in injection or nasal spray form. Basically, they simulate menopause and interfere with estrogen activity.
They’re mostly used in the short term to treat heavy periods caused by uterine fibroids or endometriosis. (More on that in a minute.)
Side effects include:
- hot flashes
- weakened bones
If medications aren’t working for you, your doctor may recommend one of the following surgical options, especially if polyps or fibroids are the cause of your heavy flow.
- Focused ultrasound: A non-invasive treatment that uses ultrasound waves to shrink uterine fibroids.
- D&C (dilation and curettage): A doctor dilates the cervix and scrapes or suctions tissue from the outer layer lining of the uterus. This is a common and simple procedure but may require several rounds.
- Operative hysteroscopy: A minimally invasive procedure that removes polyps and growths.
- Uterine artery embolization: A procedure that shrinks uterine fibroids. A surgeon inserts a catheter through a thigh artery and inserts tiny beads into the blood vessels that feed fibroids.
- Myomectomy: Surgical removal of uterine fibroids that leaves the uterus intact.
- Endometrial ablation: Using heat, freezing, radiofrequency, or laser to remove most of the uterine lining. This procedure isn’t recommended for women who hope to get pregnant later on — post-procedure pregnancy is rare and comes with a much higher risk of miscarriage and other negative effects.
- Endometrial resection: This procedure is similar to ablation — an electrosurgical wire loop removes all the uterine lining. Post-procedure pregnancy isn’t possible.
- Hysterectomy: Complete removal of the uterus. Post-procedure pregnancy isn’t possible.
As you work with your doctor to manage your heavy periods, you might want to consider these useful tools:
- Menstrual cup: These small, reusable silicone cups that fit inside your vagina are all the rage right now. They’re wallet-friendly and better for the environment. They can hold a lot more blood than pads or tampons and, when used properly, are less likely to leak.
- Period panties: These miracle unmentionables absorb blood. Thinx says their new styles can hold up to four tampons’ worth.
- Heating pad: Though it won’t lighten your flow, heat can help relieve cramps.
- Sleep: There’s a reason fatigue is a common period side effect — your body needs energy to restore blood. Rest as much as possible during your cycle. Think of it as a great time to catch up on “The Crown.”
- Exercise: Activities like yoga can reduce stress, and exercise can also help if you do have heavy bleeding.
Not sure what’s causing chronic heavy periods? These are some possibilities to investigate with your doctor:
- hormonal imbalances
- polyps and fibroids (non-cancerous tumors that grow inside the uterus)
- nonhormonal IUD
- bleeding disorders (often genetic) like von Willebrand disease (VWD)
- blood thinners or anti-inflammatory meds
- thyroid problems
- pelvic inflammatory disease (PID)
- kidney disease
- liver disease
- reproductive cancers (these are rare)
If your period is unusually heavy for more than 1 to 2 months and is cramping your uterus and your lifestyle, schedule a checkup.
Tell your healthcare provider if you have:
- bleeding heavy enough to need a tampon or pad change every 1 to 2 hours (or wearing two pads to prevent bleeding through)
- middle-of-the-night tampon and pad changes
- bleeding lasting more than 7 days
- cramps so painful you have to skip activities
- blood clots the size of a quarter or bigger
- bleeding between periods
- shortness of breath
- excessive tiredness
- irregular heartbeat or dizziness
Your doctor will want to know:
- your and your family’s medical history
- the start and end dates of your last few periods
- how heavy your flow is
- how many pads or tampons you normally use
Most of the time a heavy period is nothing to worry about. But there’s no reason to dwell in a scarlet hell.
You can manage your menstruation mayhem by adding iron and vitamin C to your diet, taking OTC meds, and staying hydrated. If that isn’t enough, talk to your healthcare provider about one of the many meds that can help.
You know your cycle best, so if it seems a little too extra, talk to your healthcare provider. They’ll be able to offer additional options like birth control or run some blood tests to check your iron levels and thyroid function.