After a miscarriage or pregnancy loss, some women have heavier and longer periods than normal. I was one of those women. It can be hard to manage those very heavy periods, and they can even be more painful than normal. A heavy period can be disruptive at work or at home and could lead to anemia. Periods should return to normal in 3-6 months after pregnancy loss, but you don’t need to just suffer through it. Here are some strategies you can use to survive those heavy periods.
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What is a heavy period?
A heavy period, also called menorrhagia, is when you are losing too much blood during your period. It is typical to lose 2-3 Tablespoons (30-44 mL) of blood during a period. Those with heavy periods may be losing more than 5 Tablespoons (80 mL) during a period. Of course, this isn’t something that most of us usually measure, but if you are using a menstrual cup you might have a rough idea.
Signs you have a heavy period
- Period lasts longer than 7 days
- Pad/tampon changes every 1-3 hours on the heavy days
- Needing to change a pad or tampon overnight during sleeping hours
- Doubling up on period products
- Packing a change of clothes when you leave the house during a period because of leaks
Why are periods sometimes heavier after miscarriage and pregnancy loss?
Hormones like estrogen and progesterone regulate your menstrual cycle. Miscarriage and pregnancy loss can cause an imbalance in these hormones, and it takes some time before everything returns to normal. Periods should return to normal in 3-6 months after pregnancy loss.
When should I contact my provider about my heavy periods?
If your periods aren’t back to normal in 3-6 months, you should contact your provider. However, if you are concerned, I would encourage you to contact your provider even sooner than that. I waited longer than I should have. It was clear I was losing a lot of blood. I was not feeling well at all, and it was interfering with my work, my life, and even our plans for trying to conceive (TTC). When I finally spoke with my provider, and learned about options to help, I was relieved. And I wished that I had reached out sooner.
Strategies for surviving heavy periods
Naproxen
Over-the-counter Naproxen can actually help reduce bleeding for women with heavy periods. Excessive levels of prostaglandins can cause heavy menstrual bleeding. Naproxen is an NSAID (non-steroidal anti-inflammatory drug), and NSAIDs block prostaglandins. A Cochrane review of 18 randomized control trials found that NSAIDs were effective in reducing heavy menstrual bleeding when taken during your period (bleeding days). It is worth mentioning that there are certain prescription drugs including prescription NSAIDs and hormonal treatments that you and your provider can also consider depending on your needs and situation.
Menstrual cup
A menstrual cup is a period product that is a reusable alternative to pads or tampons. If you’ve never heard of them before, a menstrual cup is a flexible, silicone cup that is inserted to catch period blood. I’ve used them for many years, but I was especially happy to have my menstrual cup during my heavy periods in the months after my first miscarriage.
I have found menstrual cups to be comfortable, to the point that I can often forget that it’s there. But the best part for heavy periods is that they can hold as much blood as 3-4 ultra tampons! That meant that I was able to work and sleep without having to change period products so often or worry about leaks. Menstrual cups come in different sizes, but even the small one holds 25 mL.
If you aren’t sure how to get started or what size you need, many manufacturers sell 2-packs with a small and a large menstrual cup, like this pack from Lena. Manufacturers often state on packaging that women who have previously given birth will likely need the large size, but I use the small size to get a good, leak-free fit and I did have a vaginal birth. If you are struggling with frequent tampon/pad changes and leaks that are affecting your life, please consider a menstrual cup because it could be a life-changer.
Heating pad
If I’m having painful period cramps, my heating pad is my best friend. It has also helped me through my miscarriages at home, making the pain bearable. It’s a simple thing, but totally worth it for cramping and period pain.
Iron supplement
While an iron supplement isn’t going to fix your heavy periods, you may need it if you are having heavy menstrual bleeding. Heavy bleeding can lead to anemia. In an article in the American Family Physician Journal, of those women who were diagnosed with menorrhagia by a physician, 58% had a history of anemia and 4% needed iron infusions.
While you should talk with your provider before taking an iron supplement, there are many options for over-the-counter iron supplements that you could take. Iron supplements can lead to constipation, so make sure you keep enough fiber in your diet or choose a gut-friendly iron supplement. While I have taken regular iron tablets and liquid iron, my current choice is the iron supplement by Vitron C. This iron supplement contains vitamin C too, which improves iron absorption. It is also gradual release, which I feel has reduced any constipation or nausea that I would sometimes get from my iron supplements.
Hormonal birth control
Hormonal birth control pills and hormonal intrauterine devices (IUDs) can reduce heavy period bleeding, or even eliminate a period altogether depending on how they are taken. I won’t go into specific types, as these are all prescribed or placed by your doctor who knows far more about them than I do. If you are hoping to try to conceive (TTC) soon, this may not be an ideal option for you. However, if your heavy bleeding is a big issue in the months after your pregnancy loss, it may be worth considering.
Vitex Berry (Chasteberry)
Vitex berry is a supplement that my provider recommended I use for my short menstrual cycles, heavy periods, and spotting between periods. While vitex berry is an herbal supplement that is sold over-the-counter, it is powerful and you should only take it if your provider recommends it. I will be honest with you: I still don’t really understand how it works.
Vitex berry is thought to be helpful for those with irregular menstrual cycles and luteal phase deficiency, as it affects prolactin and progesterone levels. It worked for me to regulate my menstrual cycle. But it is definitely not for everyone and should be used with caution. Feel free to look into it and bring it up with your provider, but DO NOT just order a bottle and start taking it on your own without professional guidance for appropriate timing and dosage.
Citations
- https://www.miscarriageassociation.org.uk/blog/periods-after-pregnancy-loss/
- https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding
- https://www.aafp.org/pubs/afp/issues/2020/0801/p147.html
- Lethaby A, Duckitt K, Farquhar C. Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD000400. doi: 10.1002/14651858.CD000400.pub3. Update in: Cochrane Database Syst Rev. 2019 Sep 19;9:CD000400. doi: 10.1002/14651858.CD000400.pub4. PMID: 23440779.
- Apgar BS, Kaufman AH, George-Nwogu U, Kittendorf A. Treatment of menorrhagia. Am Fam Physician. 2007 Jun 15;75(12):1813-9. PMID: 17619523.
- https://health.clevelandclinic.org/chasteberry-benefits-and-risks
- https://www.larabriden.com/vitex-for-period-problems/