What are the causes of painful and heavy periods? What are the symptoms of heavy menstrual bleeding and dysmenorrhea? How are painful and heavy periods diagnosed by healthcare providers?

Causes of Painful and Heavy Periods

Painful and heavy periods, also known as menorrhagia and dysmenorrhea, can be caused by a variety of underlying conditions. Some common causes include:

• Adenomyosis: When the endometrial tissue that normally lines the inside of the uterus grows into the uterine muscle wall.
• Bleeding disorders: Inherited conditions like von Willebrand’s disease that prevent proper blood clotting.
• Cancer: Cervical or uterine cancer can lead to heavy menstrual bleeding.
• Endometriosis: When endometrial-like tissue grows outside the uterus on other pelvic organs.
• Medications: Certain blood thinners, anti-inflammatory drugs, or hormonal medications can cause heavy bleeding.
• Polycystic ovary syndrome (PCOS): A hormonal disorder that can lead to irregular and heavy periods.
• Pregnancy complications: Miscarriage or ectopic pregnancy can result in heavy bleeding.
• Premature ovarian failure: When a woman’s ovaries stop functioning normally before age 40.
• Uterine fibroids: Noncancerous muscle tumors that grow in or on the uterus.
• Uterine polyps: Overgrowths of endometrial tissue that form inside the uterus.
• Hormonal imbalances: Often related to perimenopause or conditions like PCOS.

Symptoms of Painful and Heavy Periods

Signs and symptoms of heavy menstrual bleeding (menorrhagia) include:

• Bleeding for more than 7 days
• Needing to change pads or tampons hourly for several hours
• Using multiple pads to control flow
• Changing pads or tampons during the night
• Passing blood clots larger than a quarter
• Flooding clothing or bedding with menstrual blood
• Symptoms of anemia like fatigue and shortness of breath

Symptoms of menstrual pain (dysmenorrhea) include:

• Diarrhea
• Headaches
• Lower back pain
• Nausea
• Throbbing or cramping lower abdominal pain

When to See a Doctor for Painful and Heavy Periods

Patients should see their doctor if they experience any of the following:

• Periods stop for more than 60 days
• Periods become irregular or erratic
• Periods are less than 21 days or more than 35 days apart
• Bleeding between periods
• Bleeding after sex
• Any vaginal bleeding after menopause
• Sudden fever and feeling sick after using tampons

Diagnosing Painful and Heavy Periods

To diagnose the cause of heavy, painful periods, healthcare providers will typically perform the following:

• Physical exam
• Review of medical history and menstrual cycle details
• Discussion of symptoms
• Blood tests to check for anemia, thyroid disorders, or clotting issues
• Ultrasound to look for uterine abnormalities
• Pap smear to check for cervical issues
• Endometrial biopsy to sample uterine lining tissue
• MRI scans to further evaluate pelvic anatomy

Specialized Care for Painful and Heavy Periods

UT Southwestern’s gynecologists and specialists have extensive experience diagnosing and treating the causes of irregular, heavy, and painful menstrual periods. Our team participates in research to improve care for women’s health issues and educates future women’s health providers.

Seeking Treatment for Painful and Heavy Periods

If you are experiencing heavy, painful, or irregular periods, schedule an appointment with a UT Southwestern gynecologist. Our experts can determine the underlying cause and develop an individualized treatment plan to help manage your symptoms and address the root issue.

Key Takeaways

Painful and heavy periods can have a variety of causes, including hormonal imbalances, uterine abnormalities, and underlying medical conditions. Symptoms may include excessive bleeding, passing large clots, and severe menstrual cramps. Seeking medical evaluation is important, as the cause must be properly diagnosed in order to receive effective treatment.