8 Reasons for Heavy Painful Periods

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Heavy periods are common. In most cases, no cause can be found. In certain situations, a root cause of the issue can be identified, for example, endometriosis, fibroids, and other medical issues. There are several methods that can be used to alleviate the severity of heavy menstrual cycles and make them more workable. Possible treatments for this condition range from taking medications to decrease bleeding, insertion of an intrauterine device, typically referred to as a coil, into the uterus, to surgical intervention.

Many women describe their periods as heavy. It can be tricky to determine if the amount of bleeding during one’s menstrual cycle is typical or excessive in comparison to other females. Some women who believe that their menstrual flow is particularly heavy might actually be losing an average amount of blood. Some women who feel as though their menstrual cycles are average may, in fact, be experiencing excessive bleeding. A large portion of the blood loss usually occurs during the initial three days of normal or heavy menstruation.

There are many reasons for heavy, painful periods. It is a fact that many individuals experience cramps and heaviness while they are menstruating; however, this does not signify that these symptoms are typical. Any type of pain is an indication that your body is alerting you to look into a disparity inside of it.

Endometriosis is an extremely painful menstrual condition that requires a doctor’s evaluation. This health issue can cause debilitating cramps and discomfort, which are often caused by an abnormal increase in uterine tissue located in another part of the body.

A heavy period consists of…

  • A period lasting longer than 7 days
  • Losing more than 80 mL of blood per cycle (or 16 regular tampons or pads)
  • Changing tampons or pads every hour or two
  • Needing to double up on period protection products
  • Having to wake up to change your tampon or pad in the night
  • Planning activities around your heavy period
  • Blood clots the size of a quarter or bigger

Here are 8 reasons for heavy, painful periods:

1. Prostaglandins

Heavy, painful periods can be attributed to Prostaglandins. Prostaglandins are hormones that are of a sexual nature and work in the opposite direction to progesterone. When the amount of progesterone drops immediately prior to a woman’s period, then the prostaglandin level will rise. The purpose of them is to make the uterus clamp down and get rid of the inner surface. During childbirth, these spasms facilitate the delivery of the baby, but typically, these cramps are just known as cramps. Prostaglandins are involved in pain and inflammation. High levels of prostaglandins can mean more severe pain. When prostaglandin levels are elevated, progesterone levels drop, leading to an imbalance between estrogen and progesterone and other common symptoms, such as breast soreness, migraines, queasiness, and exhaustion.

2. High Estrogen

Excess estrogen can be a factor that causes agonizing periods with heavy bleeding. Bleeding heavily can be attributed to polyps, which form when there is an increased formation of tissue in the womb. Elevated levels of estrogen can lead to heavier and more painful periods because of the manner in which it helps to construct the endometrial wall during menstruation. Higher amounts of estrogen can result in an increase in prostaglandin levels, which can lead to more sensations of pain.

3. Low Progesterone

One of the causes of intense, painful menstruation is a deficiency in progesterone. When the reproductive cycle is typical, the ovum is discharged from the follicle and the created sac, known as the corpus luteum, will secrete the hormone progesterone after discharge of the egg. Anovulation results in the non-release of an egg and a decrease in progesterone production by the corpus luteum, causing lower levels of progesterone in the blood. Furthermore, a lack of progesterone can cause estrogen levels to rise in the body, causing more intense menstrual flows.

3. Poor Estrogen Detoxification

A further cause of serious, uncomfortable menstrual bleeding is inefficient elimination of estrogen. Period pain is caused by high levels of estrogen; if your body finds it difficult to remove or detoxify estrogen, it will remain in the body and lead to increased levels of estrogen. An disproportion of estrogen relative to progesterone can be caused by increased estrogen levels, resulting in a condition known as estrogen dominance. The normal elimination of estrogen from the body is something that our liver, kidneys, and intestinal tract should be able to do on their own. However, these procedures can become sluggish or malfunction because of a variety of causes. The detoxification process for eliminating estrogen requires 3 principal stages. Initially, the estrogen is turned into a different substance, afterward, that material is packaged in combination with a nutrition like amino acid, and in the end, the freshly made compound is eliminated from the body.

4. Gut Issues

Digestive troubles are a leading contributor of intense discomfort due to the mixtures of bacteria that support the process of digestion and are sustained by fiber. We desire a wide variety of this beneficial bacterium in order to break down food. Gut dysbiosis occurs when the number of bacteria and other microorganisms in the intestines is out of proportion. The unevenness of bacteria leads to menstrual pain due to the fact that the gut regulates estrogen. This is done with the help of an enzyme that changes it into its active form for discarding, but when it does not function correctly, an increase of recycled estrogen can take place. When the normal bacterial count in your gut is disturbed, the digestive process can be impaired, resulting in increased estrogen levels. This is why problems in the gut are regularly linked to menstrual cramps.

5. Stress

Another reason for heavy painful periods is stress. When we are faced with mild or extreme danger, our body emits a reaction known as stress. The body responds to stress by secreting larger amounts of cortisol, a hormone produced by the adrenal glands, which is known as a stress hormone. If your cortisol level is too high, the balance between estrogen and progesterone will be disturbed since cortisol is a hormone. Due to this, tension can exacerbate menstruation cramps on account of stimulating an inflammatory response while simultaneously disrupting the hypothalamic-pituitary axis answer in the memory section of the brain. This area of the brain is responsible for the secretion of hormones, which facilitate the reproductive process.

6. Genetics

Genetics can be another cause of severe, agonizing menstrual cycles. Nerve growth factor has been found to be an indication of a genetic influence in pelvic pain. The link between inflammation and the potential of predicting reproductive diseases and conditions is the cause of this. This data indicates that cramps during menstruation may be an inherited trait in some families, running in the gene pool. You need to remember that although cramps related to your period can run in your family, it is still possible to do something to reduce the discomfort they cause.

7. Ovarian Cysts

Ovarian cysts are a signal of PCOS, and they can lead to extremely agonizing and heavier than normal periods. These sacs, which are located in the vicinity of the ovaries, contain either fluid or solid material. Approximately 10 percent of females have a cyst, some women are born with them while others acquire them from other sources. In addition, some cysts are harmless and do not cause any discomfort, but others can be quite painful and increase in size. Signs of a cyst on the ovaries may be abdominal ache, infrequent menstruation, intense twinges, and distress during the time of urination. One of the indications of inadequate progesterone is the presence of cysts, which is why they commonly lead to excessive menstrual bleeding. In a research done on dairy cows, it was discovered that a single shot of progesterone during the beginning of cyst development decreased its duration and some instances were seen with the return of ovulation.

8. Endometriosis

One more cause of severe, painful periods is Endometriosis. Endometriosis is a medical status where endometrial tissue develops in areas other than the uterus, generally found in the fallopian tube, vaginal passage, or ovaries. This material is responsive to estrogen, and augmentations in estrogen can cause more heightened menstrual bleeding and discomfort in the lower abdomen. Women who experience high levels of estrogen in their bodies tend to suffer from endometriosis, which typically leads to heavy menstrual bleeding.

What Are the Treatment Options for Heavy Periods?

Your physician must give your signs consideration, inquire the accurate queries, and use the best examinations to identify the origin of your strong menstrual cycles without unnecessary postponement. The type of treatment that is given will depend on what the underlying cause is, although in many cases the exact reason will not be known. Despite this, there are still various ways to make periods less intense. Your physician will outline the advantages and potential side effects.

Treatment aims to reduce the amount of blood loss. This leaflet goes on to provide information on potential treatments for females who experience frequent and severe bleeding but who do not have an identifiable source of their condition. This is the majority of cases. If an underlying condition, such as a fibroid or endometriosis, is present, possible treatments may vary.

Not treating

This might be an appropriate choice if your menstrual cycles do not significantly disrupt your daily life. You can be certain that your heavy periods are not a sign of anything serious and you may be able to cope with them. A doctor may suggest having a blood test routinely to determine if there is an anemia issue. Iron tablets can correct anaemia.

Levonorgestrel intrauterine system (LNG-IUS)

The LNG-IUS treatment usually works very well. The LNG-IUS is similar to an IUCD, or coil. An implant containing levonorgestrel, a progestogen hormone, is placed within the uterus and releases a tiny amount of the hormone over time. The quantity of hormone secreted every day is minuscule yet adequate enough to be effective within the uterus. After 3 to 6 months of this treatment, the majority of women experience a marked decrease in bleeding or it completely ceases. Period pain is usually reduced too. The primary action of the LNG-IUS is to decrease the thickness of the uterine wall.

The LNG-IUS is a long-acting treatment. The typical lifespan of a device is five years, though it can be removed prior to that. One version, called Jaydess®, only lasts for three years. It can be employed as a form of birth control, as well as to alleviate heavy menstrual cycles. It may be worth looking into this kind of LNG-IUS as it is smaller and more easily accommodated than others, especially if you have not had kids.

LNG-IUS is especially beneficial for women who wish to have long-term birth control, as it is dependable in preventing pregnancy. It is usually not recommended to use contraception if you don’t need it for an extended period of time (at least one year).

Tranexamic acid tablets

Tranexamic acid pills can be used instead if the LNG-IUS is not desired or appropriate. Using tranexamic acid can decrease the amount of bleeding by almost 50% in most situations. Despite this, there is no decrease in the quantity of days of menstrual flow or in menstrual cramps. You must ingest a pill 3-4 times daily for a period of 3-5 days. Tranexamic acid inhibits the dissolution of blood clots in the uterus. The end result is that the blood clots in the inner wall of the uterus become firmer, which leads to less bleeding. In the event of side-effects, they tend to be relatively minor, though they can include discomfort in the stomach area.

Anti-inflammatory painkillers

There are various types and brands. Ibuprofen can be purchased from pharmacies, while other medicines must be obtained via prescription. Your physician may suggest other medications such as mefenamic acid or naproxen. In the majority of circumstances, these medications can cut back bleeding by approximately one fourth. They also ease period pain. You should consume the pills over a span of a few days while you are menstruating. They decrease the elevated amount of prostaglandin in the mucous membrane that lines the uterus. This chemical has been linked to an increased likelihood of having heavier periods and more severe period pain. Nevertheless, they do not cut down the amount of days the time frame continues.

In a few people, there may be resulting issues such as a disturbed stomach. If you have had an ulcer in either your stomach or small intestine, or suffer from asthma, it is necessary to consult with a doctor before taking these medications.

A number of female individuals consume both anti-inflammatory analgesics and tranexamic acid pills during several days over each menstrual cycle, given that they provide different results. This mixture of tablets has proven to be effective for many females who experience menstrual bleeding that is unusually heavy.

The combined oral contraceptive (COC) pill

Most women experience at least a third less bleeding due to this. It often helps with period pain too. Many women who are looking for contraception but would not like to utilize the LNG-IUS usually opt for this treatment. You may take this in addition to anti-inflammatory painkillers if necessary, especially if you are having issues with cramps. Please refer to the separate document entitled The Combined Oral Contraceptive (COC) Pill for further information. Some other methods that function in a similar fashion are hormonal contraceptive rings or patches which are combined.

Long-acting progestogen contraceptives

The contraceptive injection and the contraceptive implant often result in decreased menstrual flow. Around half of the women who take the contraceptive injection may not experience a period in the 12 months following. They are not prescribed exclusively for excessive menstruation. If you need birth control, then one of these could be a viable choice for you.


Norethisterone is a hormone (progestogen) medicine. It is not commonly used to treat heavy periods. In certain circumstances, this treatment may be deemed necessary if other treatments have been unsuccessful, deemed inappropriate, or refused. Norethisterone should be ingested during days 5-26 of the menstrual cycle (commencement of the cycle being the first day of the flow). Using norethisterone in this manner does not serve as a form of birth control.

The lower effectiveness of norethisterone when compared to the other treatments allows it to be rarely used as a regular medical plan. Also many women develop side-effects. Norethisterone may be used as an intervention for very intense menstruation.

Other medicines

Specialists in hospital at times turn to the usage of other hormonal therapies, for example, GnRH analogues. However, these treatments are not done regularly because a wide range of side effects often arise.


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