Heavy Periods

In this episode we discuss:
- The difference between Normal and Heavy periods
- Causes of Heavy periods
- Solutions!

Find out if your period is actually NOT NORMAL and what you can DO ABOUT IT!

Transcript

SPEAKER_00: 0:00

Hey guys, welcome to another episode of 4 Vaginas Only. In this episode, we are going to discuss heavy periods. But before we get into it, let's bop a little bit to this music. Hello and welcome to 4 Vaginas Only, the podcast about everything female. I'm your host, Dr. Celestine, bringing you important information about understanding your health and body in the way you wish your doctor would actually explain it. Alright. So hi everybody, I'm Dr. Celestine or Dr. C as you know me. And in this episode, we're going to discuss heavy periods. So we're going to first touch a little bit on what's a normal period versus a heavy period. Then I'm going to go into a lot of the causes of heavy periods, which it's pretty vast. There's a lot of different reasons why your period can be heavy. And then we're going to discuss some of the treatment options that are available to you if you fall into the category of someone that has a heavy period. So let's get into it. Firstly, I want to say that I apologize in advance for sounding a little nasally in this episode. I just got back from vacation and I got a little bit sick on the trip and it's lingering, but you know, the show must go on. So let's get into it. All right. So the reason we're talking about this topic is because heavy periods are so common. According to the CDC, about 10 million Americans have heavy periods per year, which translates to about one in every five women. That's a lot. And without even seeing these statistics, I know that because I see it in my practice every single day. So let's touch on the menstrual cycle in general. Every month, a female should have a period. And the menstrual cycle is a monthly cycle where hormones go up and down in order to make certain things happen. You ovulate every month, which is creating like a cyst or an egg on the ovary. And then shortly after that, you have a period. If you want to hear a little bit more about ovarian cysts, look at my last episode because I talk a lot about that there. Okay, so this might be a little weird because we think of the ending of the menstrual cycle as when you have your period. But actually, it's technically the beginning of the menstrual cycle because the first day that you bleed, we consider day one of the menstrual cycle. So when you start bleeding, a normal period lasts anywhere between two to seven days and you will never have heavy bleeding. Some people measure it by tablespoons. If you look at my four vaginas only Instagram page, you'll see that I have a post about heavy periods and I talk about measuring it in tablespoons. But in reality, no one is sitting there filling up tablespoons of blood as they're bleeding, right? So when a period is normal versus heavy, we talk about how many pads or tampons you're filling up with blood. So for a heavy or long period, that consists of a period that's more than seven days long and a on most of the days of the period, you are fully saturating pads or tampons, meaning they're filling up completely with blood and you're changing that fully saturated pad or tampon every one or two hours. That's considered way too much bleeding for a period. So if you fall into the category of your periods lasting longer than seven days and you're saturating pads or tampons, filling up with blood every one to two hours for multiple days of your period, then this podcast episode is for you, so welcome. All right, now the causes. You guys know that my podcast episodes are usually, unless I'm interviewing somebody, a little bit less than around like 15 minutes or so, maybe a little bit longer. So there are a lot of causes of heavy periods, and I'm going to touch on all of them, but I might not go into full detail on everything because it gets to be a lot. I will say here, if you have a heavy period, see your doctor because We have to investigate what exactly is the cause. But just as an overview, let's talk about the different causes. Okay, so I'm going to break it down into structural causes, hormonal causes, and then sort of an other category. So structural causes include actual things that we can visualize and see for the most part. Those include polyps, fibroids, and endometriosis or adenomyosis. So polyps are kind of a soft tissue structure. You can have polyps inside the uterus within the lining of the uterus that can cause heavy or long periods. You can also have polyps within the cervix, which is the opening to the uterus that your doctor can actually see when they do a vaginal exam, and that can cause period issues. Fibroids are more of a solid structure. tumor that is benign. It's not cancerous for the most part. And those are usually on top of the uterus, within the uterus muscle, and can also be inside the uterus where the lining of the uterus is as well that you bleed out every month. And then we have endometriosis and adenomyosis. I put them together because they're sort of similar. Endometriosis, we can't necessarily visualize when we do an ultrasound, but there are some telltale signs of an exam that can point it out. Adenomyosis can actually be visualized as kind of different... colors. I know ultrasounds are black and white, but you can kind of see different shading on the uterus that looks like it's round like a fibroid, but there's no actual mass there. It's the lining of the uterus that is kind of embedded into the muscle or musculature of the uterus, and that is adenomyosis. And that can cause heavy and prolonged periods as well. And those are the structural causes. Then we have hormonal causes, which kind of falls into, I know it's very catchy now, the hormonal imbalance, which I don't truly, I'm not like a believer in, sorry. Mainly because, yes, there is such thing as your hormones causing heavy, painful periods, but the imbalance part I'm not sold on. We can get into that maybe in another episode. But here are some hormonal reasons that can cause your periods to be heavy or prolonged. One of them is if you have PCOS or polycystic ovarian syndrome. I also talk a lot about that in another podcast episode. So look through the episodes. There's an episode dedicated completely to PCOS. But usually when you have that, you're also having skipped periods and some other signs of PCOS. But it can cause heavy periods. Another thing people don't think about is obesity. If you technically fall into the category of being obese, that can cause heavy periods due to hormones because fat cells actually exude or produce estrogen. You probably have a little higher estrogen than someone that's not obese. And estrogen is part of the menstrual cycle. Estrogen goes up and down. And if you have excess, it can cause excess bleeding during your period. So that's a possibility. Another hormonal problem is an actual thyroid problem or hyperthyroidism, sometimes also hypothyroidism. So a lot of times your doctor will check your thyroid hormone to see if your thyroid hormone being out of whack is the reason why you have heavy or long periods. And those are the main kind of quote hormone causes. And the last category we're going to call other, okay? Because I don't really, I can't figure out what I would call it. So other is going to work for now. And one thing that falls into the other category is a miscarriage. So if you have never had heavy periods before, and then all of a sudden you have one really heavy and prolonged period, and you're not using protection when you have sex, and you're not on birth control consistently, your doctor might check a pregnancy test because it could be a miscarriage, okay? The other cause is actually having cancer or precancerous changes inside of the uterus, inside of that lining that you bleed every month. I more commonly find this in my postmenopausal women. So if you haven't had a period for one year and you're older in age, usually around 51 to 52, that is menopause, okay? And if you have any bleeding at all after menopause, we need to rule out cancer or pre-cancer inside of the uterus because that can be a cause of bleeding. If you're younger and you have this, it can also have a cancer or pre-cancer inside the uterus, especially if you have a history of or currently are rather obese. Because like I said, you have higher estrogen and that contributes to the uterine lining growing kind of abnormally. So we need to rule that out. There are also bleeding disorders. So if you know you have a bleeding disorder like hemophilia or von Willebrand's disease, that can be causes of heavy periods. And I usually see that in younger girls. After they start having periods for the first time, then their periods are really, really heavy. We usually rule... bleeding disorders out as well. But you also have other signs of that too, nosebleeds, easily bleeding of your gums when you brush your teeth, things like that can be signs. And last but not least, certain medications can cause heavy or long periods. For example, if you're on a blood thinner like Lovenox, Heparin, Xarelto, Eliquis, these medications can cause your periods to become heavy and long. All right, so you're listening to this episode, you're like, hmm, yeah, I have heavy periods. wait a minute, I have some of these causes or people have told me I have polyps or fibroid or maybe I'm obese or I have thyroid disorder. Could that be the cause? Now you're wondering, well, what the hell do I do? What are the treatments? So let's get into that. First and foremost, iron. So if you're bleeding heavily and you should make sure that your blood count gets checked with a CBC and maybe your iron levels as well. Because when you're bleeding a lot, your iron gets really low. That can cause things like heart palpitations, dizziness. You can faint. And if it gets really low, you can even have things like a heart attack. So being on iron if your blood count is low is important, whether that's getting IV iron or oral iron. So that's first and foremost while we figure out the cause and treatments. So here are some treatment options that may work for you that you should go over with with your doctor. I'm just going to talk about them in general. One is ibuprofen. So not only does ibuprofen help with period pains if you're getting them during your heavy periods, but it can also decrease the amount of bleeding that you're having just a little bit. So that can be beneficial in some women to use ibuprofen during their periods. Next is some type of birth control. Now I always talk about birth control as just being hormones in So just like you take pills for high blood pressure or diabetes, it's just another medication that helps with a lot of different things. Yes, they prevent pregnancy, but we also use them a lot for heavy and prolonged periods. So whether that's the pill, the patch, the ring, the injection, the IUDs, the implant in your arm, all of these can be used to help prevent pregnancy. heavy and prolonged periods. Because like I talked about, the menstrual cycle is a hormone fluctuation going up and down each month. So these medications help to stabilize the hormone levels and decrease the amount of fluctuation, which decreases the heaviness and length of your period. Another medication that can be used is what we call antifibrinolytic. I can't even pronounce it, right? It's hard. Antifibrinolytic medications. So fibrin is... Transcripts provided by Transcription Outsourcing, LLC. stops blood clots from breaking down, meaning that it keeps the blood that's coming out of your uterus kind of congealed so that it all comes out instead of breaking down and prolonging and making the bleeding heavier, if that makes any sense. So that's a medication that some people can use during each period to decrease the amount of bleeding that they're having. There are a lot of contraindications, meaning there are some reasons why your doctor won't be able to prescribe it to you, but it is a possibility for some women. And last but not least, are surgical procedures. So the first surgical procedure that can be performed is something called a hysteroscopy with possibly a dilation and curatage of the uterus. That's when we look into the uterus with a camera. Sometimes we do that to determine if there's something inside of there that's causing your problems. And then we take a sampling of the lining or thin out the lining. One, the sampling can help us rule out a cancer or a pre-cancer. And two, the actual... method of kind of scraping the lining of the uterus can decrease your heavy periods in the long term. So it's sort of part of a diagnosis and a treatment. The next surgery is an endometrial ablation. That's when we go into the uterus with a device that opens up kind of like a little fan, fills the cavity of the uterus, and actually burns the lining of the uterus. And that can decrease your periods and sometimes stop your periods altogether. The next procedure that is possible to be used to help as a treatment is something called a uterine artery embolization. That's actually done with a radiologist, those people that do ultrasounds and CT scans and all of that, and they inject something into the blood supply of the uterus that cuts off some of the blood supply. We use that a lot in people that have fibroids, no longer wanting to have children, and that can, in certain conditions, with certain causes of heavy periods, help to decrease. the amount of bleeding that you're having. And last but not least, the definitive surgery of a hysterectomy. And that's where we actually take the uterus out of your body surgically. So we call it definitive because that's the end-all be-all. You remove the uterus, which means you remove the lining that's inside of the uterus, and then there's no more periods. That's a big major surgery. The others I talked about are more of an outpatient surgery and are minor surgeries. This one is a major surgery, but it's definitive. Take it out and it's done. Obviously, you can't have any more children after your uterus is out, but in some situations, it's very beneficial to do that procedure. And that's it. So that is kind of the overview on heavy periods, talking about what's normal versus what's heavy, a lot of the different causes of heavy periods, as well as some treatment options. So I hope that this is very helpful for a lot of you all out there, the one in five that the CDC states that has heavy periods. So I'm really hoping that this helps guide kind of First of all, it helps you understand that what you're going through is actually not normal. A lot of people live with heavy periods and they think, oh, it's always been that way and that's just it for them. But it's not normal. So it's hopefully, one, causing you to figure that out. And two, prompt you to go see your doctor to figure out what the cause is for you. And then help you kind of have a little bit of ammunition in terms of discussing some of the treatment options that you might want to do and some of the ones that you don't want to do because that's important as well. So overall, I hope that this has been very helpful and helps that discussion happen with you and your doctor. So thank you guys so much for listening to this episode of the Four Vaginas Only podcast. You can find a lot more information on my Instagram page. It is called Four Vaginas Only as well. And you can email me at drc at fvonly.com. Bye. Bye.

UNKNOWN: 16:31

Thank you.