6 causes of heavy periods and when to see a doctor, according to OB-GYNs

• Your period may be heavy because of your birth control, medications, or an underlying condition.
• A heavy period is one that lasts longer than a week and requires more than one tampon per hour.
• To stop heavy periods, reach out to your OB-GYN who may put you on birth control or pain medication.

Although heavy periods are common - affecting more than 10 million Americans a year - that doesn't mean they're normal, and it may be a sign of a serious health concern.

"An occasional period that is heavier than normal is not generally concerning. However, if periods are consistently heavy … you should see an OB-GYN," says Pinar H. Kodaman, MD, an OB-GYN at Yale Medicine and associate professor of clinical obstetrics, gynecology and reproductive sciences at the Yale School of Medicine.

Signs of a heavy period

Your period is considered heavy if you experience any of the following signs and symptoms:

• A period that lasts more than a week
• Passing blood clots as big as or larger than a quarter
• Requiring one or more tampons or menstrual pads every hour for several consecutive hours
• Having to change menstrual products during the night
• Wearing more than one menstrual pad to control the bleeding

Here are six potential causes of heavy periods and how to treat them.

1. Copper intrauterine device (IUD)

"[Copper IUDs] can make periods heavier and crampier by causing inflammation and changing the blood flow to the uterus, especially during the first few months after insertion," says Kodaman.

In fact, a large 2014 study involving participants with hormonal IUDs, copper IUDs, or contraceptive implants found that more than 70% of copper IUD users experienced heavier bleeding within the first three months of insertion compared to before insertion. About 25% reported lighter bleeding at the six-month check-in.

How to treat it: Heavy bleeding from a copper IUD can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, a prescription drug called desmopressin, or tranexamic acid, which improves blood clotting, says Anne L. Banfield, MD, FACOG, director of Women's Health Services at the Davis Medical Center and vice chair of the West Virginia section at the American College of Obstetricians and Gynecologists.

2. Bleeding disorders

Bleeding disorders, such as von Willebrand Disease or hemophilia, can cause heavy periods because the blood does not clot properly. In fact, an estimated one in 10 people with heavy periods may have a bleeding disorder, according to a 2001 report. Typically people are diagnosed during adolescence when they first begin their period.

Other symptoms of bleeding disorders include frequent nosebleeds, frequent bruising, and blood in the stool or urine.

How to treat it: There's no cure for bleeding disorders, but taking hormonal birth control, iron supplements, or desmopressin may control heavy bleeding by returning red blood cell levels to normal or increasing the amount of clotting factors in your blood.

3. Non-cancerous fibroids or polyps

Benign growths may impair the uterus' ability to stop and prevent bleeding - leading to heavy periods. There are two kinds of growths:

• Fibroids, which are growths in the uterus that affect about 20% to 70% of women.
• Polyps, which are growths in the lining of the uterus that affect anywhere from 7.8% to 34.9% of women

Other symptoms of these growths include pain or bleeding during sex and bleeding between monthly periods.

How to treat it: Taking hormonal birth controls may help. However, various surgical treatments to shrink or remove the growths - such as ultrasound surgery, myomectomy, or hysterectomy - may be necessary to control the bleeding.

4. Medications

Blood thinners like aspirin or anticoagulants like warfarin and heparin may cause you to have heavier periods. In fact, about 70% of women taking anticoagulants may find that it affects their menstrual flow.

This is because blood thinners slow down the body's blood-clotting process and can even prevent blood cells from forming .

How to treat it: Heavy bleeding due to anticoagulants can often be controlled by getting a hormonal IUD, taking tranexamic acid during your flow, or using the birth control pill.

However, treatment for heavy bleeding due to necessary medications must be discussed with your doctor to determine the best option for you and your medical conditions. Especially since, patients who need blood thinners and/or daily aspirin should often avoid using estrogen-containing medications, says Banfield.

5. Hormonal imbalance

"Conditions causing irregular ovulation, such as puberty, perimenopause, polycystic ovary syndrome (PCOS), and hypothyroidism, may be hormonal reasons for heavy periods," says Banfield.

Other signs of hormonal imbalance include:

• Weight changes
• Irregular bowel movements
• Low libido

However, these symptoms are non-specific and may indicate many other conditions.

How to treat it: Heavy bleeding from a hormonal imbalance can be treated by managing the underlying issue. This may mean taking a synthetic thyroid hormone medication for hypothyroidism or oral medications for PCOS, like combination birth control pills or progestin therapy.

"Hormonal contraceptives, such as the birth control pill, are frequently used to control heavy periods and for cycle regulation once the underlying cause of the heavy bleeding is identified and addressed," Kodaman says.

6. Adenomyosis

Related Article Module: What is adenomyosis? The uterine condition that causes painful periods

Adenomyosis is a condition where the tissue lining the uterus grows into the uterine muscle wall. This tissue can cause the uterus to swell, leading to abnormal uterine bleeding. It affects about 20% to 65% of menstruating people and causes other symptoms like pelvic pain and painful sex.

How to treat it: The only way to cure adenomyosis is to have a hysterectomy, which removes the uterus altogether. However you may be able to manage the condition by taking pain medication and hormonal birth control.

Additionally, symptoms - including heavy bleeding - typically resolve after menopause.

Insider's takeaway

An occasional heavy period is normal, but you should consider seeing an OB-GYN if you experience:

• Blood clots the size of a quarter
• Filling tampons so quickly that you must use multiple ones within several hours
• Having your period for more than a week

The cause could be a serious underlying condition like fibroids, polyps, or adenomyosis. Or, it could also be due to a copper IUD or certain medications you're taking. The best way to find out is to speak to a professional.

Gynecologic exams, cervical cultures, and routine Pap smears may be needed to rule out other possible causes of abnormal bleeding, says Kodaman. This includes changes in the uterine lining, structural problems of the uterus, or cervical abnormalities.

"Anyone who perceives their period as heavy or problematic should discuss this with their doctor," says Banfield. "It is always important if heavy bleeding occurs that pregnancy is eliminated as a cause for the bleeding episode."

Are irregular periods normal? 10 common causes and when to see a doctorA guide to picking the right tampon size for your period6 reasons for bleeding after sex and how to prevent it, according to OBGYNs10 signs your period is coming - plus, tips on how to ease PMS