Heavy Menstrual Bleeding: What’s Normal & When to Seek Help

Women's Health Practice in Rochester, NY

Monthly periods can be an incredibly different experience for every woman. Some women are blessed with quick, light periods that hardly affect their life at all. Others deal with painful cramping and heavy bleeding that often disrupt daily activities. A lot of women fall somewhere in between.

This disparity in periods between women can make it difficult to know if what you experience is normal. For example, heavy bleeding is a common issue that many don’t seek help for, simply because they don’t realize it’s abnormal.

What is considered “normal” menstrual bleeding?

The average amount of blood a woman loses over the length of her period ranges anywhere from 5 to 80 milliliters, or about 6 tablespoons. This amount varies greatly between women. What’s heavy for you might be normal for someone else or vice versa. Hormonal birth control can also make your periods lighter.

What is considered “abnormal” or heavy menstrual bleeding?

Typically, if you’re losing more than 80 milliliters of blood during your period, or your period lasts longer than 8 days, this is considered heavy bleeding. Menorrhagia is the medical term for abnormally heavy periods.

A good way to tell if your flow is heavier than it should be is by how quickly you soak a pad or tampon. If you have to change them once every hour or two, this is not normal. The size of any blood clots you pass can also indicate too much blood loss—anything bigger than the size of a quarter is of concern, if passed regularly. You should also not be bleeding through your clothes or bedding, or have to wake up at night to change your pad or tampon.

What are the complications of heavy periods?

Long and heavy periods can significantly impact your quality of life and, sometimes, your health. Too much menstrual blood loss can lead to anemia and severe cramping, while constantly needing to change sanitary products can disrupt your daily activities and cause stress.

If your period flow is so heavy that it’s getting in the way of your life or stressing you out, you should talk to your doctor about possible causes and solutions.

What causes heavy periods?

Hormone Issues

Hormone imbalances can cause your endometrium (uterine lining) to become too thick, leading to heavy bleeding when it sheds during your period. Puberty, perimenopause, hypothyroidism, and PCOS are all conditions that can result in hormone problems.

Copper IUD in Rochester NY

Birth Control

Recent changes in your birth control regimen can be responsible for heavier periods. Recently stopping or switching hormonal birth controls, for example, can cause temporary hormone imbalance as your body adjusts. The copper IUD is also known to cause heavy periods for the first few months after insertion.


Adenomyosis is a condition in which endometrial tissue embeds and grows in the uterine wall, causing heavy and sometimes painful periods.

Uterine Fibroids & Polyps

Uterine fibroids and polyps are both tissue growths that can occur in the uterus. Fibroids are benign and polyps, although usually benign, can be cancerous or precancerous.

Other Potential Causes:

  • Ectopic pregnancy
  • Endometriosis
  • Bleeding disorders
  • Blood thinners
  • Anti-inflammatory medications
  • Pelvic inflammatory disease
  • Uterine cancer (rarely)

How are heavy periods treated?

Treatment for heavy periods usually involves either treating the underlying condition or regulating blood flow. Common treatments include:

  • Birth control
  • GnRH agonists to stop cycle or reduce fibroids
  • Non-steroidal anti-inflammatory drugs (NSAIDs) to control bleeding and relieve cramps
  • Prescription medications
  • Dilation & curettage (D&C) procedure to remove layers of uterine tissue
  • Surgery to treat polyps, fibroids, or endometriosis
  • Hysterectomy (in extreme cases where other treatments have failed)

If you experience pain or bleeding with your periods that disrupts your everyday life, make an appointment with a women’s health specialist at South Avenue Women’s Services. We provide full-service well woman care, including expert diagnosis, treatment, and surgery, to restore health and quality of life to women throughout Western NY.

Give us a call at 585-271-3850 to schedule a visit or learn more about the full scope of women’s health services we offer!