Updated 13 June 2013

Heavy bleeding: the key facts

Are there two days out of every month that you scrap from your social calendar and bond with your duvet? Do you buy painkillers and sanitaryware in bulk?


Are there two days out of every month that you scrap from your social calendar and bond with your duvet? Do you buy painkillers and sanitary towels in bulk?

You are in good company: one in every five women has experienced similar problems at some time in their lives.

Normal blood loss during menstruation is around 80ml, or a third of a teacup, but some women bleed up to ten times as much. This could be due to a condition known as abnormal uterine bleeding (AUB), or to menorraghia. It is a distressing and painful experience which can leave you feeling drained, anxious and depressed.

Menorraghia is a common disorder in which women have an unusually heavy or prolonged menstrual flow. It can also be defined as a deviation from someone's typical menstrual pattern: a need to increase the use of sanitary pads or tampons by more than two a day; or a period that lasts three or more days longer than usual.

Heavy bleeding is particularly common during the last two to three years before menopause or the first few years after menstruation begins.

Heavy menstrual bleeding is mostly caused by hormonal problems. Hormonal imbalances occur when your body produces too much or too little of certain hormones. These imbalances often occur when women have lost or gained weight, used certain medications, exercise too much, and are ill or stressed. If the heavy bleeding is a once-off occurrence, it could be that you have just experienced abnormal stress.

Women who bleed very heavily during menstruation are often not ovulating regularly. The production of progesterone, the hormone that keeps periods regular, accompanies ovulation. Chronic failure to ovulate could lead to polycystic ovarian disease. The main symptoms of this are irregular uterine bleeding, acne, excessive facial hair, obesity and infertility. Treatment for this is usually the contraceptive pill, which sorts out hormonal imbalances within a cycle or two.

There are many medical conditions which cause heavy menstrual bleeding. These include liver or kidney disease, miscarriage, ectopic pregnancy, fibroids and diabetes.

Excessive bleeding is not normal and should be checked out by your GP or gynaecologist. Your body could be trying to tell you that something more serious is wrong.

- (Susan Erasmus, Health24, updated February 2011)

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