What Can I Do About My Heavy Period?

Heavy periods can be miserable when you have to run to the bathroom every couple of hours to swap in clean gear. Fix this mess, you beg the universe.

The good news is that there are many possible treatments. If one solution doesn’t work, you can try another to end the hassle, which medically is called “abnormal uterine bleeding.”

Start with an Internal Exam

The first step is to see a gynecologist about your heavy menstrual bleeding. After an exam and possibly testing, your doctor will try to find out why your flow is so strong, then recommend ways to dial it back.

To evaluate your symptoms, your doctor will take a detailed history to help discover why your period is abnormally robust. How long has this been going on? How different is your flow from the past? Have you noticed anything that makes the bleeding worse? Did it begin after a pregnancy? The doctor will also do a pelvic exam to look for abnormalities in your cervix, such as inflammation or polyps, which might be causing your issue.

Plenty of other conditions could be the culprit. Among them are bleeding disorders, hormonal issues, thyroid dysfunction, uterine or cervical cancer, and miscarriage or ectopic pregnancy, according to the Centers for Disease Control and Prevention. But usually, the cause is far less serious.

To get a comprehensive look at your female organs— the uterus, ovaries and fallopian tubes —you might have a transvaginal ultrasound, with or without fluid in the uterine cavity, and/or an MRI. Those will provide images that show growths and other abnormalities. In some cases, you may have other tests: a CT Scan X-ray or a biopsy of the inner lining of your uterus, to rule out malignancy.

Treatments That Don’t Involve Surgery

Even with those options, doctors can’t always pinpoint the cause of heavy bleeding. Yet they can treat it. Depending on your diagnosis, or lack of one, you’ll be given choices that might rein in the bleeding. Here are the most common ones:

• Birth control pills. Birth control pills regulate menstrual cycles, so you might benefit from them even if you’re not sexually active. Over time, most women bleed far less each month.
• IUDs. Intrauterine devices often control bleeding, especially if it is caused by the lining of the endometrium. Expect a version that has progesterone in it. IUDs are a top choice for teenagers and young women who dislike weight gain from birth control pills or can’t remember to take a pill daily. But a small percentage of women find IUDs uncomfortable. IUDs can be removed safely when you want to get pregnant.
• Hormones. Once you enter the perimenopausal phase, hormone supplements can be effective.
• Nonhormonal medications. Tranexamic acid curbs the speed of blood clots breaking down, making women bleed less.

Surgical Solutions

Doctors always aim for the least invasive intervention, but sometimes surgery is the best method to end heavy bleeding.

Surgery is also the only way to take out growths such as polyps and fibroid cysts. Whether done in a doctor’s office, outpatient center or hospital operating room, most procedures are simple enough that patients can go home the same day and the healing will be fairly rapid. Here’s what your doctor is likely to suggest.

• Hysteroscopy. If there is a fibroid within your uterine cavity, your doctor will probably perform a hysteroscopy. This involves placing a tiny camera in the uterine cavity, then removing the growth. A lab will examine the removed tissue to make sure it’s not cancer. In most cases, the procedure alone will lead to lighter menstrual cycles for at least two years. More fibroids may grow, but they develop slowly.
• Robotic or traditional myomectomy. If you have multiple fibroids and they are causing pain or heavy bleeding, you might have a surgery called myomectomy to take them out. If you’re a candidate, you can opt for a robotic/laparoscopic approach, which is the most time-efficient method. With a laparoscopic procedure, the doctor will make a few small incisions through your abdomen, one to insert a camera so the doctor can see inside, others to place instruments to help take the fibroids away.
• Hysterectomy. If you’re past your child-bearing years and want or need to put an end to gynecological issues, you might opt for a hysterectomy. That involves having your uterus, cervix and fallopian tubes removed — but not necessarily your ovaries, as in years past. The ovaries help keep bones, brains and hearts strong until up to age 65, so having a hysterectomy does not mean going into menopause. Hysterectomies, too, can often be performed laparoscopically, leading to relatively quick recoveries.

Whether with a pill, a simple procedure or a minimally invasive surgery, your gynecologist can curtail your uncomfortably heavy bleeding and make you comfortable once again.