There is a medical definition of “too-heavy periods”. If a woman is bleeding 80cc (2.7 ounces — about 1/3 of a cup) or more, that is excessive bleeding. Some general indications of excessive bleeding can include:
- Saturating a maxipad or super tampon every 60-90 minutes for several hours
- Passage of large clots (quarter sized or larger)
- Significant bleeding for more than seven days
Probably the most important factor would be if your bleeding is heavy enough to interfere with your normal activities.
There are two major reasons for very prolonged/heavy periods: hormonal and “structural”.
Hormonal causes are usually linked to missed or erratic ovulation. In a normal cycle, estrogen is produced all month. In a normal cycle, progesterone production increases following ovulation. Progesterone “stabilizes” the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining — your period.
If you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don’t decline, and the lining stays up inside the uterus as a missed/late period. Alternatively the lining can begin to shed under its own weight, producing prolonged bleeding. After several months of missed periods, the lining of the uterus can become very thickened. Prolonged and heavy flows are not uncommon after months of missed flows.
A “structural” cause of heavy menstrual bleeding means that excessive bleeding is due to actual problems within the cavity or walls of the uterus. Some examples of this would include: infections of the lining of the uterus, fibroids of the uterus, endometriosis of the muscular wall of the uterus (“adenomyosis”), polyps of the uterine lining, or even uterine cancer.
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