My Period Blood is Pouring Out Like Water, Why?

If you're a heavy bleeder, you know the you know the struggle of living with periods. You've got painful cramps, frequent pad or tampon changes, and period blood pouring out like water from a broken faucet. And let's not forget the stains on your clothes and bedding after soaking through the best pads for heavy flow.

It's like your uterus is trying to make up for lost time and is determined to bleed you dry, and it's the worst.

While a heavy period may feel like the norm for some, if your flow is too heavy and is accompanied by other symptoms like dizziness and fatigue, it could be a sign of other health conditions.

To help you determine when a heavy period is a sign of concern, we tapped Dr. Sophia Yen, MD, MPH, the co-founder and Chief Medical Officer of Pandia Health, and board-certified family medicine physician Dr. Laura Purdy, MD, MBA, to discuss all there is to know about the subject, including potential warning signs and conditions that could be the underlying cause.

My period blood is pouring out like water, why?

According to The American College of Obstetricians and Gynecologists (ACOG), heavy, watery period blood may feel like the norm for some, but should not be ignored as it can interfere with daily activities and may be a sign of a larger health issue.

Some of the conditions that can result in this kind of period blood include perimenopause, endometritis, and the postpartum period, as well as hormonal imbalances, thyroid issues, and Von Willebrand disease. Here's a little more info on each.

Hormone Imbalances, PCOS, Bleeding Disorders and Fibroids 

Genetics can play a significant role in determining who experiences a heavier period, as Dr. Yen suggests that if your mother had heavy periods, you have a 50 percent chance of having the same. Similarly, conditions such as PCOS, bleeding disorders, and fibroids are all predetermined by genetics and are linked to heavier periods.

Therefore, it is important to be aware of a family history of such conditions. By doing so, you can take steps to manage your period and seek medical attention if necessary.

Von Willebrand Disease and Factor X Deficiency 

Heavy periods can be a symptom of undiagnosed bleeding disorders, such as Von Willebrand Disease (VWD), which, according to Dr. Yen, can be identified by heavy periods from the start of menstruation. VWD can cause prolonged bleeding after surgery, easy bruising and bleeding after tooth brushing. If you are experiencing any of these symptoms, Dr. Yen says is important to consult with a doctor.

According to MedlinePlus from the National Library of Medicine, factor X deficiency is another bleeding disorder that can result in heavy and protracted periods. Similar to VWD, factor X deficiency can result in nosebleeds, gum bleeding, and frequent bruises; a physician should be consulted for a diagnosis.

Perimenopause, Endometriosis, and Postpartum

If you are of age and experience heavy menstrual bleeding out of the blue, Dr. Purdy says that perimenopause could be the cause, even if you don't typically have heavy periods. The ACOG states that perimenopause occurs between the ages of 45 and 55. This time is characterized by smaller ovaries and lower estrogen levels.

It is best to see your gynecologist for additional evaluation testing to confirm this.

Another possible cause of heavy periods is endometriosis. According to MedlinePlus from the National Library of Medicine, this condition is common and is characterized by heavy and painful periods. Endometriosis can affect women who start their period very young, though genetics plays a significant role in who develops it.

A gynecologist should confirm endometriosis, just like with perimenopause.

Last but not least, heavy periods may also occur during the postpartum period. Dr. Purdy says that this occurs as your body adjusts and should resolve in four to six weeks. "If you are recovering from childbirth you may also notice heavier periods as your body is adjusting," she tells Today's Parent.

Why does my period gush when I stand up?

According to Dr. Yen, the sensation of period blood gushing out when standing up is due to gravity pulling the blood out and abdominal muscles pushing the blood out. Dr. Purdy explains that the same thing happens when lying down, as it is a result of inactivity and being idle for a period of time.

While this is not a cause for concern, you'll always want to be mindful of how much blood you are passing during your period. It could be dangerous to pass too much blood, so you should get medical help immediately.

It makes sense to wear pads with wings on your heaviest flow days. We like these super absorbant winged pads.

Can a heavy period make you pass out?

While cramping, aches, and pains are typical period symptoms, fainting is not, according to Dr. Purdy. But Dr. Yen warns that if this does happen, it might be due to anemia, which can make a person faint.

"If you experience heavy periods, it's important to watch for symptoms of anemia, such as feeling cold, feeling tired, dizzy when getting up fast, and looking pale," she says. "If you experience any of these symptoms, see blood clots the size of a quarter or bigger, or go through a pad or tampon faster than once every two hours, go to urgent care or the emergency room."

What are the dangers of a very heavy period?

Although heavy menstrual blood (and bright red blood) is not always a cause for concern, there are certain warning signs that suggest it could be indicative of a more serious health issue. This includes iron deficiency and anemia, which, Dr. Yen says, if left untreated can cause heart damage.

"You can have severe anemia causing you heart damage if it goes on for months or more," she tells Today's Parent. "Symptoms of anemia are feeling cold, feeling tired, dizziness when getting up fast, and looking pale."

Dr. Purdy advises seeking medical attention if you are experiencing severe cramps and passing large blood clots or if your period is making it difficult for you to perform daily activities. Although it's uncommon, Dr. Yen adds that if you lose a lot of blood during your menstrual cycle, you might need a transfusion.

FAQs

How common is a very heavy period?

Because each woman's menstrual cycle is unique, some women may consider a heavy period to be the norm. However, Dr. Yen stresses that an extremely heavy period should not be taken lightly and requires medical evaluation.

"If you have a very heavy period (soaking through the pad/tampon more frequently than every two hours or blood clots bigger than a quarter), that is not normal and you should see a doctor," she says.

Is a very heavy period influenced by genetics?

Yes, a lot of people with heavy periods are genetically predisposed to it. So, there is a good chance that you will experience heavy periods if your mother did. Your genes can also affect some health issues connected to heavy periods. Fibroids, endometriosis, PCOS, and bleeding issues are a few of these.

Can heavy periods affect fertility?

A 2016 Boston University School of Health article states that heavy bleeding and fertility are usually unrelated to heavy periods. However, according to the Centers for Disease Control and Prevention, bleeding and clotting disorders can contribute to reproductive issues like pregnancy complications and recurrent fetal loss.

For this reason, if you are trying to conceive and have any concerns, it is advised that you speak with your OB/GYN. If you are also experiencing irregular period bleeding, Dr. Purdy suggests that it may be a sign of an ectopic pregnancy or miscarriage, both of which can also indicate a heavy menstrual period.

You'll also want to keep in mind that endometriosis can also have an impact on your fertility, as MedlinePlus from the National Library of Medicine states those with this condition may have difficulty getting or staying pregnant.

When do I see a doctor for a very heavy period?

According to Dr. Yen, you should consult a physician if you need to change your tampon or pad every hour or if you pass blood clots or uterine lining bigger than a quarter, as these indicate heavy menstrual bleeding. If you experience any of the following symptoms of anemia: pale skin, fatigue, coldness, and lightheadedness when standing up too quickly, you should also consult a physician.

It is also advisable to visit a doctor if there is a family history of heavy menstrual bleeding, as this could indicate other medical conditions like fibroids, bleeding disorders, or PCOS.

How do you treat a very heavy period? 

The ACOG suggests that heavy periods can be managed with various medications and treatments. These range from hormonal contraceptives such as hormonal birth control, hormone therapy, and other prescription medications. NSAIDs can be used to manage pain and cramps associated with heavy periods and heavy blood flowing.

However, the ACOG states they may not reduce the amount of bleeding. No matter the cause, you should always consult a medical expert. By doing this, you can pinpoint the cause of heavy bleeding, receive a diagnosis, and look into your options for treatment.

Experts:

• Dr. Sophia Yen, MD, MPH, the co-founder and Chief Medical Officer of Pandia Health
• Board-certified family medicine physician Dr. Laura Purdy, MD, MBA