Heavy Periods: Information for Young People

What causes heavy periods, and does this mean I will always have heavy bleeding?

When young people start having periods, bleeding can occur unpredictably. This means that your bleeding might occur more often, or less often, than every month. The bleeding may be sporadic, that is your period may occur one month and not the next month. When your period is irregular, it can be heavier (and might be more painful) than when a period occurs every month. Irregular periods occur because of hormonal changes, which usually improve with time. It can take a few years from when your period starts for it to become more regular.

A less common reason your period may be heavy is if you have a bleeding condition. This occurs in approximately 20% young people with heavy periods, compared to 1-2% of people in the general adult population. In people with bleeding conditions, your period can remain heavy, even if your period occurs monthly. Other symptoms that occur more often in people with bleeding conditions include easy bruising, recurrent nose bleeds, bleeding from your gums during teeth brushing, or bleeding post surgery. If you have heavy periods, it is useful to complete a bleeding assessment test, which can help determine if you need testing for bleeding conditions. A validated screening test in young people can be found on LetstalkPeriod, and you can give the result to your doctor.

Having a heavy period when you are young doesn’t mean you will always have a heavy period. As discussed above, often hormonal imbalances are reasonable for heavy periods when you are young, and these improve with time. Heavy periods in older people are more commonly due to structural causes, that is changes within the uterus itself. That is why older people will usually have a pelvic ultrasound when they have heavy periods to try to determine the cause. In younger people, an ultrasound is often not required in the first instance.

How can I manage my heavy periods?

There are several options for managing heavy periods. The choice of management depends on several factors including how troublesome your bleeding is for you, and how significant your blood loss is for your body.

Mikhaila will discuss the benefits and disadvantages of each option for you to help decide on the best choice for you.

Regardless of what option you choose, it is important to ensure you have enough iron in your diet. Iron is important for your health and wellbeing, and a significant amount is lost whenever you have a heavy period. Therefore, it is important you eat food rich in iron including red meat and spinach. If your diet doesn’t contain much iron, or if you have low iron on your blood tests, iron supplements may be required.

Being patient and seeing if your period gets better with time

Your period may become less heavy with time. If your bleeding is not bothering you, and your iron levels and blood count are stable, waiting to see if your period gets better with time is very reasonable.

Medications

There are two types of medication that can be used for improving heavy periods. These include non-hormonal medication and hormonal medications.

Non hormonal medications: These tablets can be used for many conditions, including heavy periods. The tablets are taken when you are having your period, rather than every day of the month. They include tranexamic acid, which helps the blood to clot, and non-steroidal anti-inflammatory medications, which reduce the amount of prostaglandins released during your period. Overall, they reduce your blood loss up to 60%. Non-steroidal anti-inflammatory medications are most useful in those with heavy and painful periods.

Hormonal medications: These medications contain progesterone and/or estrogen, which are similar to the hormones your ovaries naturally produce. They come in many forms including tablets, injections, a small implant that is inserted under the skin and an intrauterine device that is inserted into the uterus. If you choose hormonal tablets, you must take a tablet every day of the month, rather than just when your period occurs. They are associated with up to 100% reduction in heavy periods depending on which medication you use. They can also be effective at reducing painful periods, premenstrual symptoms such as bloating, irritability, headaches, and can provide effective contraception.

Surgery 

Surgery is very rarely required for management of heavy menstrual bleeding in young people.

When should I see Mikhaila?

If you a heavy period that is preventing you from going to school or catching up with your friends, please give us a call to make an appointment with Mikhaila.