Author
Bowtie Team
Updated on
2025-08-14
Disclaimer: This article is translated with the assistance of AI.
That time of the month can be a real drag for women, and when heavy bleeding throws your routine into chaos, it might signal deeper health concerns. The Bowtie team dives into the signs of excessive menstrual flow, easy ways to track it, potential causes, and the importance of early diagnosis to keep you in the know.
What is Menorrhagia? Definition
Menorrhagia is defined as menstrual periods lasting 7 days or more, with excessive bleeding measured by fully soaking a sanitary pad or tampon within 2 hours, requiring replacement. Academically, losing about 60cc to 80cc or more of blood per month is also considered menorrhagia.
To simply check if you have heavy periods, see if the flow is disrupting your daily life, such as:
- Experiencing dizziness, fatigue, mild shortness of breath, or other anemia symptoms
- Passing large blood clots
- Bleeding that leaks through pads or clothing
If you suspect heavy menstrual bleeding, use this calculation method as a reference:
Menstrual Flow Calculation
| Flow Amount (Per Change) | Tampon | Pad |
| 1/3 | 1 point | 1 point |
| 2/3 | 5 points | 5 points |
| 3/3 | 10 points | 20 points |
Blood Clot Calculation
| Clot Size (Per Instance) | Points |
| 1 mm | +1 point |
| 1 cm | +1 point |
| Feeling of gushing blood | +5 points |
Using the menstrual flow and blood clot calculations, tally the scores over the total days of your period. A total score over 100 points indicates heavy menstrual bleeding.
Causes of Heavy Menstrual Bleeding
Many diseases or factors can lead to heavy menstrual bleeding, and the cause isn’t always identifiable. Common reasons include:
- Hormonal imbalance (non-functional bleeding), commonly seen in puberty and menopause
- Gynecological conditions such as miscarriage, uterine fibroids , endometritis, endometriosis , and uterine cancer
- Uterine developmental abnormalities like double uterus or septate uterus
- Influence from foreign objects, such as wearing an intrauterine device (IUD)
- Medication effects, such as taking certain Chinese herbs like ginseng, dong quai, or white phoenix pills
- Internal medical conditions like blood disorders or hypothyroidism
- Emotional factors like mental stress or excessive worry
Effects of Heavy Periods on Body
Heavy menstrual bleeding can have negative impacts on the body, including:
- Anemia
- If menstrual flow is excessive, it can lower red blood cell levels in the body, increasing the risk of iron-deficiency anemia. Patients may experience rapid heartbeat, pale skin, shortness of breath, and fatigue.
- Menstrual cramps
- Heavy bleeding is often accompanied by menstrual pain, and in severe cases, painkillers or medical attention may be needed.
- Psychological distress
- Long-term heavy bleeding can cause ongoing worry and anxiety about sanitary pad leaks, leading to daily life disruptions.
How to Diagnose the True Causes of Heavy Menstrual Bleeding?
1. Pap Smear Test
| Process | The doctor uses a speculum (also known as a “duckbill clamp”) inserted into the vagina to locate the cervix, then gently scrapes cells from its surface using a small wooden stick or plastic brush for laboratory testing. |
| Possible Diseases Discovered | Cervical inflammation, cervical intraepithelial neoplasia (precancerous changes in the cervix), cervical cancer |
2. Endometrial Biopsy
| Process | The doctor uses a speculum (also known as a “duckbill clamp”) to gently open the vagina and expose the cervix, inserts a plastic suction tube through the cervix into the uterus to extract a small amount of endometrial tissue, which is then sent to the pathology department for diagnosis |
| Possible Diseases Discovered | Endometrial cancer, abnormal endometrial tissue or cellular changes caused by hormonal level variations |
3. Transvaginal Ultrasound
| Process | Insert the ultrasound probe into the vagina, allowing the doctor to directly examine the uterus and ovaries |
| Possible Diseases Discovered | Nabothian cysts, cervical polyps, uterine fibroids, endometrial hyperplasia, ovarian cysts, teratomas |
4. Hysterosalpingography
| Process | Insert a catheter into the vagina, inject contrast medium through the cervix into the uterus, then take X-ray images |
| Possible Diseases Discovered | Polyps, fibroids located in the uterine cavity or protruding into the cavity |
5. Hysteroscopy
| Process | Insert a thin hysteroscope through the vagina into the uterus, providing a clear view to examine the uterine cavity |
| Possible Diseases Discovered | Abnormal uterine bleeding, suspected Müllerian anomalies (congenital diseases related to internal genital malformations), removal/collection of abnormally growing endometrial tissue or pregnancy tissue , removal of foreign bodies |
6. Dilation and Curettage
| Process | Insert a speculum into the vagina to dilate the cervix, then insert a hysteroscope into the uterus. At the same time, insert surgical instruments into the uterus to collect tissue or polyps from the uterus and send them to the pathology department for testing |
| Possible Diseases Discovered | Abnormal uterine bleeding, suspected Müllerian anomalies (congenital diseases related to internal genital malformations), removal/collection of abnormally growing endometrial tissue or pregnancy tissue , removal of foreign bodies |
Treatments for Heavy Menstrual Bleeding
Doctors will tailor the most suitable treatment plan based on the severity and cause of heavy menstrual bleeding, by reviewing your medical history, age, overall health, and personal preferences.
Common treatments include:
| Treatment Methods | Treatment Process | Effects |
| Prescription Oral Medications | Taking oral medications, including:
|
Pain relievers: Ease menstrual pain
Hemostatic drugs: Reduce menstrual flow Iron supplements: Improve anemia symptoms Contraceptive pills: Regulate periods and reduce flow Hormonal treatments: Decrease menstrual flow |
| Intrauterine Device (IUD) with Medication |
|
Reduces heavy menstrual bleeding |
| Hysteroscopic Endometrial Resection / Ablation |
|
Removes the uterine lining to reduce menstrual flow |
| Dilation and Curettage (D&C) / Suction Curettage |
|
Removes the uterine lining to reduce menstrual flow |
| Hysterectomy |
|
Eliminates menstruation entirely |
Dietary Remedies for Heavy Periods
If you’re dealing with heavy menstrual bleeding, your body’s iron levels and red blood cells might drop. We suggest tweaking your diet to replenish nutrients and ease discomfort.
| Nutrients to Supplement | Recommended Foods |
| Iron | Red meat, poultry, fish, lentils, nuts, seeds, legumes, dark leafy greens, peas, and beans |
| Vitamin C | Lemon juice, tomatoes, bell peppers, broccoli, and citrus fruits |
| Vitamin B12 | Yogurt, eggs, milk, fish, clams, salmon, tuna, or poultry |
| Omega-3 | Flaxseeds, eggs, salmon, and walnuts |
| Zinc | Oysters, beef, kelp, cereal flakes, and peanut butter |
FAQs on Heavy Menstrual Bleeding
1. I’ve always had heavy periods since young—is this normal?
Menstrual flow varies from person to person and can fluctuate due to hormones, so even the same individual might experience heavier or lighter periods at times. Typically, days 2 to 3 of your cycle are the heaviest, tapering off afterward.
Normality isn’t just about volume—watch for sudden changes in flow or accompanying symptoms like severe pain.
2. Sudden heavy bleeding with clots—does this mean something’s wrong?
Sudden heavy flow with clots is a classic sign of uterine fibroids —it’s best to consult a doctor for professional advice.
3. Does heavy bleeding mean I’m approaching menopause?
Many conditions or factors can cause heavy periods, and it’s also a common occurrence for women nearing menopause .
4. How does TCM view heavy periods? Any related acupoints?
From a Traditional Chinese Medicine (TCM) perspective, heavy menstruation mainly falls into three types (qi deficiency, blood heat, and blood stasis). Qi deficiency often stems from a weak constitution, fatigue, or irregular diet. TCM believes qi deficiency fails to control blood flow, leading to excessive bleeding.
These four acupoints are linked to heavy periods—gentle pressure can promote qi and blood circulation, regulate cycles, and support uterine and ovarian health:
- Guanyuan point: Four finger-widths below the navel
- Sanyinjiao point: Four finger-widths above the inner ankle protrusion
- Yinlingquan point: On the inner calf near the thigh junction, about one finger-width forward in the depression
- Taichong point: On the top of the foot, two finger-widths (index and middle) up from the junction between the big toe and second toe
5. Can essential oils help improve heavy periods?
Using essential oils with massage can help alleviate heavy menstrual flow and provide relaxation to ease discomfort.
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