How heavy is too heavy for peri-menopause periods?

Read the full video transcript below

Today's topic

Hello, and welcome to my weekly video blog. And today on A.Vogel Talks Menopause, I'm going to be discussing heavy periods, and when are periods too heavy in the peri-menopause, and when is it time to do something about it.

Now, this is one of the questions we get asked so much these days. So many women find that their periods are starting to change, they're starting to maybe get a bit heavier, or longer, or closer together, and they start to get worried but they don't know whether they should be seeing their doctor, whether they should be taking anything, or whether they should just be letting things stay as they are. 

Common period changes during peri-menopause

So let's have a little look at what happens in this situation. As you approach the peri-menopause, at some point, your hormonal balance starts to change, and this is when it can affect your period. There's usually three different ways that this can sort of manifest, if you like.  

For some women, their hormonal changes are quite abrupt, and their periods just stop and that's it, and they don't get anymore back at all. For some women, they find that their periods start to get lighter, they start to get shorter, they start to get further apart, or they start to miss. And the other group is the women who find that their periods start to get closer together, they start to get heavier, they start to get longer, and this is the group that I'm really looking into today. 

Heavy periods during peri-menopause

Now, why does this happen? It's all to do with the way in which your own hormonal balance is changing, and for this particular group of women, we find that having heavy periods tends to be caused by too much oestrogen in one way or another, mainly. So what happens when you start the peri-menopause is that your progesterone levels start to drop, but your oestrogen levels can stay that little bit high. 

And what happens here, the more oestrogen that you have in relationship to progesterone and the longer it stays high can determine how long your periods are going to be. So in this instance, if your progesterone keeps falling, but your oestrogen doesn't fall as much every month, then that's going to trigger longer periods and heavy periods, but this is where it gets really confusing with hormones, because the opposite can sometimes happen, and if you get a very sudden drop of oestrogen, exactly like you would in the week before a period, then that can trigger periods, too.  

So it's really difficult to figure out exactly what's going on because it could be very high oestrogen causing the problems, or it could be the fact that you keep getting very sudden dips of oestrogen that's triggering these periods, so really very, very confusing.

When are heavy periods considered too heavy?

So when is this in a situation when you're bleeding too much? Normal periods for most women are probably roundabout five days, four to five days. Some women find that at the beginning of their period, they might have a couple of heavy days and then the last two or three days tend to get lighter and lighter. For some women, it's the opposite way, their period start to come on gradually and then they may start to get periods a little bit heavier on the last maybe two or three days.  

If your periods start to increase by another couple of days, that's usually considered okay. Some women also find that instead of getting periods every 28 days, they start to come every 23 or every 24 days roundabout that mark. Again, that is usually fine. But it's when things start to change more that there can be problems.  

If you are getting heavy bleeding for more than seven days at a time, if you find that the time between your periods is getting shorter and shorter, then you need to go and get this checked out by your doctor. What we have found is that some women will be bleeding practically continuously for weeks at a time, sometimes even months at a time, and they're sitting worrying about what's going on.  

So bleeding for more than 7 days at a time, periods coming closer together less than maybe 20 days in between, you really need to go and seek medical advice.

Why it’s important to consult your doctor

Very often, it's nothing to worry about. It's just the way your own hormonals are behaving, but, and this is one of the big buts if you like, a lot of women can have fibroids, little fibroids, which are growths in the womb that they don't realise they've had because they've never caused any problem at all.  

But when the hormones start to change, this might end up disrupting them in some way, and they can contribute to the bleeding. Some women can end up with little cysts, or there's also other growths called polyps as well. All of these could be contributory factors and it's really important that you seek medical advice to make sure that there's nothing else like these situations going on. 

Anemia due to heavy or prolonged periods

Now, one of the other things that can happen very quickly, only after one or two heavy or prolonged periods is that you can get something called anemia. And anemia is low iron. You lose iron through bleeding, and if you're having very prolonged periods or periods very close together, then your body can't make up that shortfall, and low iron will cause a whole raft of symptoms that are very similar to menopause ones.  

So low iron is going to cause fatigue, it's going to cause joint pains, it can cause sleep problems, it can cause anxiety, it can cause stress, it can cause depression, and if you have anemia long enough, you may find that your hair starts to get very brittle, your nails will start to get very brittle and stop growing properly. So as you can see, the symptoms of anemia could very well be mistaken for menopause ones.  

So if you're in this situation, it's really important to get a proper check from your doctor. They can check your iron levels and if necessary, they can recommend an iron supplement. If you want to go natural, I know some people don't like the doctor's iron tablets because they can cause constipation and black stools, which is not very pleasant, there are really nice forms of gentle iron that you can get, either in liquid forms or in tablets, and you will get those from your local health food shop.  

So hopefully, I've explained this a little bit more. If any of you have any issues like this that you're really worried about, then please just drop me a little question at the end of this, and I will be happy to help.

But ladies, it's really important here if you are worried about your periods in any way, shape, or form, please seek medical advice because at the end of the day, it's probably completely natural, it's just the way things are going, but you worrying about things is only going to make it worse, so please just go and see your doctor for peace of mind.  

And hopefully, I will see you next week for another edition of A.Vogel Talks Menopause.