All we want is a regular menstrual flow, but sometimes you can experience light or heavy periods too. Menorrhagia or excessive menstrual blood loss is a major cause of gynaecological diseases.

In India, menstrual disorders are common among women who are in the reproductive age group. But there are cultural reasons due to which menstrual problems often get unreported, according to a 2019 study published by National Library of Medicine. Women need to know how to spot the signs of too much blood loss during periods.

To know about excessive bleeding during menstruation, Health Shots contacted Dr Malini RS, Consultant – Obstetrician and Gynaecologist, Motherhood Hospitals, Whitefield, Bengaluru.

What is menstruation?

Menstruation, which a lot of women call periods, is a natural process that takes place in the female reproductive system. Dr Malini says it is the endometrial (uterine lining) shedding, which happens around once a month. Menstrual cycle helps to prepare our body for a future pregnancy and when there is no pregnancy, the uterus sheds its lining, which causes vaginal bleeding.

Signs you are losing too much blood during menstruation

Menorrhagia is characterised by bleeding that lasts more than seven days. Here are some indicators of high menstrual bleeding:

1. Passing huge blood clots

Heavy bleeding during menstruation may be indicated by clots that are larger than a quarter in size, says the expert.

2. Heavy flow

It is good to change sanitary pads after every four or five hours. But if you notice that you are using more than one pad or tampon every two hours, this could indicate that you are losing a lot of blood.

3. Requiring many changes in sanitary protection

If you regularly need to switch between pads and tampons at night or require double protection, it might indicate severe period flow.

4. Anaemia symptoms

Excessive blood loss can result in anaemia, which can cause symptoms like weakness, shortness of breath, weariness and dizziness, says Dr Malini.

Reasons behind excessive menstrual bleeding

Excessive menstrual bleeding can be caused by various reasons. Some of the typical causes are:

1. Hormonal imbalances

It can result in heavy monthly bleeding and abnormal uterine lining growth. Oestrogen and progesterone fluctuations in particular can cause this.

2. Adenomyosis

This disorder, which causes heavy periods, happens when the tissue that borders the uterus develops into the muscular wall of the uterus.

3. Uterine polyps

These are abnormal growths on the uterus’ inner lining, and can result in severe or irregular bleeding.

4. Intrauterine devices

As a side effect, some IUD varieties might cause heavier or longer monthly bleeding.

5. Uterine fibroids

Uterine fibroids can result in severe menstrual bleeding. The good news is that these uterine growths are noncancerous, says the expert.

6. Bleeding disorders

Disorders of the platelets or von Willebrand disease might cause excessive bleeding throughout the menstrual cycle.

You should lead a healthy lifestyle to help in maintaining hormonal balance and encourage regular menstrual periods. But remember that each woman’s menstrual cycle is distinct, and what constitutes ‘regular’ can vary. You should speak to a doctor if you are worried about your menstrual flow.