What causes heavy flow?

Our flow varies throughout our cycle, but also throughout our lives. Contraception, fatigue or our age have an impact on our menstrual cycle and our menstrual flow. But no reason to panic and wonder if we are "normal". We explain everything about the reasons for an abundant flow and you may find your answers there!

What is menorrhagia or profuse flow?

It is sometimes difficult to know if our periods are heavy or if it is a case of menorrhagia. Menorrhagia refers to abnormally heavy and prolonged periods. By definition, it therefore only concerns menstruating women. 

🩸 What are the differences between menorrhagia, metrorrhagia and spotting?

Menorrhagia is an abundance of abnormal periods. Metrorrhagia, meanwhile, is the presence of bleeding outside of menstruation (outside your cycle, before puberty or during menopause). However, these two cases can also be associated: we will speak of menometrorrhagia

On the contrary, the spots are small blood discharge (few drops) outside the menstrual period. 

Now let's see how you will be able to identify the nature of your menstrual flow.

How do you know if your periods are too heavy?

🩸 How to use the Higham score calculation method to define its flow?

The Higham score is a tool used to assess the amount of blood loss during menstruation. In the form of a table, the tool works with a system of points to report according to the losses observed during a cycle.

If you are interested in this tool, you can download it here.


🩸 Define its flow by evaluating it visually.

In order to facilitate the identification of its type of flow, one can report the equivalence of the quantity in periodic protection. 

Quantity

Equivalence

Type of flow

30ml or less 

1 tampon per day or a few drops on a sanitary napkin

light flow

between 30ml and 50ml

2 to 3 tampons per day or 1 towel every 3 hours.

Average flow

between 50ml and 70ml

4 to 5 tampons per day or 2 pads every 3 hours

Abundant flow

over 70ml

1 towel every 2 hours or more

Hemorrhagic flow


🩸 Measure your menstrual flow with a menstrual cup

Another effective way to assess its flow is to use a menstrual cup. Since the blood is recovered and not absorbed, it is easier to measure the quantity passed.

A good way to learn more about her body, her menstrual cycle and the evolution of her menstrual flow within your cycles.

What are the causes of heavy flow?

🩸 Hormonal fluctuations cause heavy flow

A hormonal fluctuation can be the cause of a heavy flow. In particular the excessive production of estrogen which increases the size of the endometrium and therefore the amount of menstruation. Solutions to balance your hormones exist, you have to talk about it with a gynecologist.

🩸 Benign tumors can cause heavy periods

  • The fibroid is a lump that forms in the muscle tissue of the uterus. 50 to 80% of women will have a fibroid at least once in their life. But only 1 in 4 women will have symptoms that require treatment. They generally go unnoticed except in the case of heavy periods.
  • Polyps are formed in the uterus and are generally discovered only around forty or during an infertility check-up. Mostly benign, they disappear on their own 1 in 3 times. 

It is the main cause of abnormal bleeding in women over 40.

Be careful however, in women over 45, a biopsy will be performed to ensure that the polyp is benign.

🩸 Adenomyosis causes profuse flow

Adenomyosis is an abnormality of the junction between the endometrium (lining of the uterus) and the myometrium (muscle of the uterine wall). This abnormality causes infiltration of endometrial cells into the myometrium.

To simplify, we speak of endometriosis internal to the uterus.

50% of cases of adenomyosis present with menorrhagia.

🩸 Clotting abnormalities can cause heavy periods

Clotting abnormalities are caused by low levels of clotting factors, which are proteins needed for normal blood clotting.

Very often, it is Von Willebrand's disease or hemophilia.

Because these bleeding disorders are hereditary, women in the same family may not realize that heavy periods are not normal. This is why you should not hesitate to break the taboo of menstruation and discuss with your gynecologist, because solutions exist.

🩸 Wearing an IUD causes heavy flow

Wearing an IUD or copper IUD can cause heavier periods. It is also contraindicated for women who have heavy flow or menstrual pain. If your method of contraception does not suit you, do not hesitate to talk about it with a doctor.

What to do in case of heavy periods?

🩸 What to do when the Higham score is above 100?

In the event of a Higham score greater than 100, you should contact your gynecologist who will know which treatment is best suited. This can range from regular nonsteroidal anti-inflammatory drugs to endometrial ablation in the most extreme cases.

🩸 When to worry about heavy periods?

Fatigue and unusual hair loss should alert to a possible iron deficiency caused by heavy blood loss.

In general, if daily life is impacted and dictated by our rules, it is time to discuss the situation with a health professional.