Are You Talking to Your OBGYN About Your Heavy Menstrual Bleeding?

What you may not know about heavy menstrual bleeding.

Our menstrual periods can be like inconvenient visitors who show up every month without invitations. We know it’s coming, and all we can do is make ourselves as comfortable as possible during its stay. But what happens when our flow is literally overflowing?

1 in 3 women experience heavy menstrual bleeding, but just because it’s common, doesn’t mean it’s a “normal” period. With so many women sharing a similar experience, one would think that identifying an abnormal flow or what to do about it is common knowledge. But if we wind the clock back to high school, a typical health class may have given us general information but many of us may have never learned the ins and outs of menstrual care or concerns to look out for.

So we’re here to help. We’re not promising a full health class curriculum here but hopefully we can arm you with some information to encourage an open conversation with your healthcare provider about your heavy periods and potential treatment options.

There’s no need to suffer in silence, especially when you’re experiencing discomfort and having to rearrange your days to manage your flow.

What is considered a heavy flow?

Here’s the facts: Heavy menstrual bleeding (or HMB) is determined by the length of your cycle, how much you’re bleeding, or both. The condition is defined as the loss of approximately ⅓ of a cup of blood or more during a cycle. If you want to know exactly how much blood you’re losing, OBGYN Dr. Dawn Ericsson suggests using a “menstrual cup to discern the volume of menstrual fluid.”

If that measurement approach doesn’t work for you – according to the Mayo Clinic, some common symptoms of HMB are needing to change your sanitary pads or tampons every hour for several hours in a row (including during the night), doubling up on pads to manage your flow, having blood clots about the size of a quarter or having a cycle that lasts more than seven days.

The more you know about your own body’s cycles and symptoms, the easier it is to share and receive more personalized care from your OBGYN or other healthcare provider. While talking about periods has been taboo in our culture for centuries, we are starting to see a shift, particularly on social media, towards normalizing discussions about women’s monthly cycles. Still, sitting on a piece of paper in a hospital gown may not be the most inviting space to open up about our heavy menstrual cycle concerns. It’s important to remember that our healthcare providers are there to listen and help us.

Some ways to prep for a healthcare visit are by tracking your symptoms and writing down questions in journals or apps so you don’t forget anything.  Bring a pen and notebook or if you’re always connected to your laptop or smartphone, there’s nothing wrong with typing their responses at your next visit as you would at any other meeting where you’re receiving important information. Let’s face it, the chances of us remembering everything our healthcare provider says are pretty slim.

You can use this downloadable checklist to help you with your discussion.

Symptoms and Solutions

“Depending on the underlying cause of the heavy bleeding, some hormonal birth control methods can help to manage a heavy flow,” says, Dr. Madhu Bagaria, OBGYN and endometriosis excision specialist.

If you are considering using, or already have an IUD for birth control, you may be surprised to learn that Mirena® (levonorgestrel-releasing intrauterine system) 52mg, an FDA-approved hormone-releasing IUD, also treats heavy menstrual bleeding for up to five years in women who choose an IUD for birth control.

In a clinical trial performed in women with heavy menstrual bleeding that were treated with Mirena, almost 9 out of 10 were treated successfully―with their blood loss reduced by more than half after six months.

You may have bleeding and spotting between menstrual periods, especially during the first three to six months. Sometimes the bleeding is heavier than usual at first. However, the bleeding usually becomes lighter than usual and may be irregular. Call your healthcare provider if the bleeding remains heavier than usual or increases after it has been light for a while.

If you are thinking about an IUD for birth control, consider talking to your healthcare provider about Mirena to see if it may be an appropriate option for you.

While it’s common for women to minimize their symptoms, we have accessible solutions to address the condition and potentially improve them if we so choose. Now that you know how heavy is too heavy, if you have even one symptom, schedule a visit with your OBGYN.

INDICATION FOR MIRENA
Mirena® (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 8 years. Mirena also treats heavy periods for up to 5 years in women who choose intrauterine contraception.

IMPORTANT SAFETY INFORMATION
If you have a pelvic or genital infection, get infections easily, or have certain cancers, don’t use Mirena. Less than 1% of users get a serious pelvic infection called pelvic inflammatory disease (PID).

If you have persistent pelvic or stomach pain, or excessive bleeding after placement, tell your healthcare provider (HCP). If Mirena comes out, call your HCP and avoid intercourse or use non-hormonal back-up birth control (such as condoms or spermicide). Mirena may go into or through the wall of the uterus and cause other problems.

Pregnancy while using Mirena is uncommon but can be life-threatening and may result in loss of pregnancy or fertility.

Ovarian cysts may occur but usually disappear.

Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter, or may stop.

Mirena does not protect against HIV or STIs.

Only you and your HCP can decide if Mirena is right for you. Mirena is available by prescription only.

For important risk and use information about Mirena, please see the accompanying Full Prescribing Information.

Visit Mirena.com to learn more.

Dr. Ericsson and Dr. Bagaria do not provide paid consultation services to Bayer and are not being compensated for this information.

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