Question about heavy bleeding...
I've never had heavy periods in my life, now all of a sudden I'm on day 6 of not being able to leave the house! It slows, and I think it's letting up and coming to an end, but then the dam breaks and the gushing is back! Is it normal to slow down and then start back up again?
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Heavier bleeding is common in perimenopause, as ovulation can become less regular, resulting in less efficient hormonal control over the ultimate thickness and coordinated shedding of the uterine lining. This is called "anovulatory bleeding." The "stop & start" phenomenon is common. If the gushing goes on for days with no signs of sustained slowing, time to see a doctor in-person. Most of the time what seems like a lot of blood loss is less than it appears, but days of heavy bleeding can result in anemia and other consequences. There are many other causes of heavy bleeding, and examination is needed to determine the diagnosis and best course of action. Sometimes blood tests, biopsy of the uterine lining and imaging (such as ultrasound) are needed, in addition to physical exam. If the heavy bleeding is determined to be hormonal/anovulatory, hormonal medication can be prescribed both short and longer-term to slow and regulate it. The treatment always depends on the cause, so determining a diagnosis is the first step.
Lisa L. Savage, M.D.
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