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Heavy Periods: Could It Be Endometriosis?

Medically reviewed by: Melissa A. Delgado, MD, FACOG

Melissa A. Delgado, MD, FACOG is the founder and owner of The Chronic Pelvic Pain Center of Northern Virginia. Dr. Delgado is an experienced, board-certified OB/GYN and has spent the past 10 years dedicating her time to understanding complex and persistent pelvic pain.

Periods are never fun, but let’s face it: some days are definitely worse than others. All women have dealt with the occasional heavy flow that begs the question: Is this normal?

Here to demystify the meaning behind gushing periods and help you understand when to seek medical attention are Dr. Melissa Delgado and our team at The Chronic Pelvic Pain Center of Northern Virginia. We’ve outlined how to determine if your heavy menstrual flow is normal — and, if not, what could be the cause.

Is Heavy Menstrual Flow Normal?

Yes, heavy menstrual flow is normal. However, we understand that it may be concerning— especially if it’s a new development.

All women experience variances in their periods, including the length of their cycles, the duration of their period, and the nature of the flow. Most women can predict light and heavy days based on past experience, although they may get caught off guard now and then.

Hormone fluctuations, stress, age, and other factors may cause your period to behave differently from month to month, and one of the effects may be a heavier flow than you’re used to — that’s normal.

Here’s what’s not normal:

  • Soaking through a pad or tampon every hour for multiple hours

  • Passing large blood clots (larger than a quarter)

  • Exceeding the capacity of a pad or tampon in the middle of the night

  • Periods that last longer than a week

  • Flow so heavy it makes you restrict your activities

When you’re passing this much blood, you may also feel fatigued and have shortness of breath while doing normal daily tasks. Often, women who experience severely heavy menstrual flow (called menorrhagia) like this end up with anemia, where the blood loss affects your body’s ability to transport oxygen. If this describes your monthly menstrual cycles, it’s important to seek medical attention to treat the underlying cause.

What Causes Heavy Periods?

If you’re experiencing menorrhagia, the culprit may be one of several conditions, including:

  • Hormone imbalance

  • Ovarian dysfunction

  • Uterine fibroids

  • Reaction to an IUD

  • Polyps

  • Medications

  • Kidney or liver disease

  • Pregnancy complications

  • Cancer

One of the most common reasons for heavy menstrual flow is endometriosis, which also comes with a host of other symptoms.

Understanding Endometriosis

Up to 10% of all women experience endometriosis, the condition where your uterine lining escapes the womb and grows outside its normal boundaries. Heavy menstrual flow is a classic symptom of endometriosis; others include:

  • Painful periods

  • Painful sex

  • Long-lasting periods

  • Bowel and urinary problems

  • Nausea and vomiting

While researchers still don’t have a definitive answer for what causes endometriosis, one of the prevailing theories suggests that “reverse menstruation” may be a factor. This happens when some of the menstrual blood and tissues back up, travel through the fallopian tubes, and enter the abdomen.

Endometrial cells may also enter the abdominal cavity during a surgical procedure or through normal blood flow. Some even theorize that normal cells of other tissues (bladder, ovaries, etc.) may develop into endometrial cells. Regardless of the cause, endometriosis is treatable.

Treating Endometriosis

Dr. Delgado understands the pain and discomfort you’re experiencing with endometriosis and takes several steps to ease your symptoms. Depending on the severity and location of your endometriosis, she may suggest simple treatments such as OTC pain relievers or hormone therapy.

However, if your endometriosis begins to cause debilitating pain or threatens your fertility, surgery may become necessary. In this case, she performs a minimally invasive, robot-assisted procedure that produces excellent results with very little downtime.

There’s no reason to suffer through endometriosis, heavy periods, or pain. To find out why your periods are heavy and what you can do about it, call our Vienna, VA office at (703) 448-6070 or schedule a Discovery Call today.


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