Recognizing the signs of abnormally heavy menstrual bleeding

Women with bleeding disorders should be aware of these issues

I cannot stress enough how profoundly heavy menstrual bleeding can impact everyday life. Imagine needing to find a bathroom nearly every hour, seven days a week. It can make certain career choices extremely challenging and disrupt daily activities, including school and athletics.

When I was young, I didn’t realize my periods were abnormal. Despite being diagnosed with von Willebrand disease and hemophilia B at 10, I didn’t connect the dots. We didn’t talk about periods in my family, and since bleeding disorders weren’t a known issue for us, we were in the dark.

At a recent Coalition for Hemophilia B symposium, Jeanette Jones, who has a platelet disorder, spoke openly about heavy menstrual bleeding. She passed around cups containing 80 mL of fluid, the amount of fluid loss considered normal during a period, and shared photos of her periods to illustrate her point.

Following are some signs from my experience and Jeanette’s presentation that our periods were abnormally heavy:

Signs of heavy periods

Frequent pad or tampon changes: I couldn’t get through a one-hour class without bleeding onto my clothes in high school. Soaking through one or more pads or tampons every hour for several hours is a clear sign of heavy menstrual bleeding.

Double protection: I often used both tampons and pads together. Relying on double sanitary protection to manage my flow was not normal.

Nighttime changes: Waking up to change my sanitary protection during the night was a sign of heavy menstrual bleeding.

Large blood clots: Passing clots the size of a quarter (2.5 cm) or larger can indicate heavy bleeding.

Extended period duration: Bleeding that lasts longer than seven days is considered prolonged and may signify heavy menstrual bleeding. While I didn’t often experience this, many women with bleeding disorders do.

Impact on daily activities: Period pain and heavy flow that interfere with daily activities like work, school, or exercise could indicate excessive bleeding. I experienced considerable pain, especially in my 20s and 30s. Significant blood loss during periods that leave you extremely tired or unable to maintain your usual activity level is a concern.

Anemia or iron deficiency: Symptoms like fatigue, weakness, dizziness, or shortness of breath during your period might suggest anemia or iron deficiency. It’s essential to have your iron levels checked regularly. If you’re iron deficient or anemic, seek treatment for your bleeding disorders. As hematologist Claudio Sandoval said during a presentation at Hope for Hemophilia’s recent Prophy Conference, “Iron deficiency is quite the terrible disease.” Proper diagnosis and treatment can significantly improve quality of life.

Frequent blood stains: Regular accidents leading to blood stains on clothes or bedding can indicate heavy periods.

To better understand your bleeding, I recommend taking the self-administered bleeding assessment tool from Let’s Talk Period and sharing the results with your hematologist.

If you experience heavy menstrual bleeding regularly, consult your gynecologist to rule out conditions like fibroids or hormonal imbalances. Keeping a menstrual diary to track your period’s frequency, duration, and intensity can provide valuable information to your doctor.

Don’t hesitate to seek help and take proactive steps toward better menstrual health. Remember, managing your health is a journey, and understanding your body is the first step toward a healthier, more comfortable life.