4 Causes of Heavy Bleeding and What to Do Next

As you stroll past the light flow options in tampons and pads, you wonder what your life would be like if you didn’t have to deal with messy and uncomfortable menstrual cycles. Instead, you’re reaching for the heavy flow items, which can still fall short in keeping up with your heavy periods.

You’re certainly not alone in this struggle — heavy bleeding affects about one in 10 women who have their periods. What each of these women can confirm is that heavy bleeding is a serious quality-of-life issue.

For more than 50 years, women have relied on Bayard Street Obstetrics & Gynecology for superior, female-specific healthcare, which means we’ve helped thousands of women dealing with abnormal bleeding. Our collective team — we have locations in lower Manhattan, Brooklyn, Queens, and Long Island — presents some of the more common causes of heavy bleeding here.

Defining heavy periods

Let’s first qualify what we mean by heavy periods, which typically exhibit one or more of the following characteristics:

• Soaking through tampons or pads at least every two hours
• Soaking through period protection at night
• Bleeding that lasts for more than a week
• Bleeding with large blood clots

In severe cases, the bleeding can be heavy enough that anemia develops. Even without anemia, heavy bleeding is challenging and disruptive.

Common drivers of heavy bleeding

Heavy bleeding can stem from many different sources, but the following four causes are by far the most common:

1. Uterine fibroids

Up to 80% of women develop uterine fibroids during their reproductive years, which are noncancerous growths in the walls of the uterus. These growths all need blood, which increases the blood vessel network in your uterus. As a result, you can experience heavy periods.

The presence of fibroids can also influence prostaglandins, which are the hormones that lead to uterine contractions, or cramps. So, not only can fibroids lead to heavy bleeding, but uncomfortable cramping is often part of the picture, too.

2. Polycystic ovary syndrome (PCOS)

Another common gynecologic condition that can lead to heavy bleeding is PCOS, which affects between 6% and 12% of reproductive-age women. With PCOS, there’s a hormone imbalance that can affect your menstrual cycles, often making them erratic and fewer than normal. 

While you might think that fewer periods means less bleeding, and it does for some, for other women with PCOS, it goes in the opposite direction with heavy bleeding. When you don’t have regular periods, the lining of your uterus can thicken, which can make periods much heavier when you do have them.

3. Adenomyosis

This is a condition in which the lining of your uterus grows into the wall of the organ, and it affects between 20% and 30% of women of reproductive age.

Over time, the presence of adenomyosis can enlarge your uterus, which is what’s behind your heavy bleeding. As well, this condition can prompt moderate-to-severe cramping during your menstrual cycles.

4. Endometriosis

On its own, endometriosis can lead to heavy bleeding because the endometrial tissues that grow outside of your uterus can cause an inflammatory environment that leads to heavier bleeding from inside your uterus.

More often, however, the heavy bleeding stems from co-existing adenomyosis because the two conditions are estrogen-dependent and often co-occur.

Finding relief from heavy bleeding

The first step toward relief from your heavy periods is to make an appointment with our team so we can figure out what's behind the issue. Each of these conditions has its own treatment protocol for managing the heavy bleeding, so it’s important to start with the right diagnosis.

To get that ball rolling and get a step closer to relief, please contact Bayard Street Obstetrics & Gynecology at one of our five locations in lower Manhattan, Sunset Park, Flushing, and Syosset, New York. You can call our appointment line at 212-226-5530 or use our convenient online booking feature.