Most of us have probably experienced heavy periods some time in our lives. Some months may be normal, and other months make us feel like we live in diapers. When we are soaking through a tampon or a pad an hour, that’s probably too heavy. And certainly, if we’re soaking through a tampon AND a pad an hour, that’s definitely too heavy and medical attention is probably warranted.
Heavy periods can be caused by a variety of reasons. We have to consider 3 main categories of reasons that can cause heavy periods: systemic disease vs. anatomic disease vs. hypothalamic-pituitary-ovarian axis (H-P-O axis for short…we’ll explain below)
Systemic diseases, meaning diseases that are not part of the reproductive system, can impact how heavy or irregular periods can be. These can include thyroid dysfunction, high levels of prolactin, liver disease or kidney disease.
Anatomic diseases pertain to things that actually arise from the reproductive system like ovarian cysts, uterine polyps or uterine fibroids.
Finally, H-P-O axis refers to the complex set of signals coming from the hypothalamus (a small gland in our heads)to the ovary and vice versa. A normally-functioning H-P-O axis means that every month, the hypothalamus sends down a signal to the ovary. The ovary then produces hormones and matures an egg. (That’s right ladies, our bodies get ready for pregnancy EVERY month). If we don’t get pregnant, the egg dies off, the uterine lining is shed as a period, and the hormonal levels drop. This drop in hormonal levels signals back to the hypothalamus to send down another signal for the next month.
Many things can derail this complex orchestration of events. These can include physical or emotional stressors like a car accident, major surgery, staying up all night to study for midterms,etc.
We can check bloods tests to rule out the systemic diseases. Ultrasounds can be done in our office to check for ovarian cysts or fibroids.
Once heavy periods are determined to not be caused by any of these things, then we can talk about treatment.
Treatment can include birth control pills. Mirena IUD’s (intra-uterine device), uterine ablation procedures, or hysterectomy.