Hot Flashes And Night Sweats
One of the most common symptoms of perimenopause is hot flashes, which often coexists with night sweats. Almost 80 percent of people who are in perimenopause or transitioning into menopause have hot flashes. Also, most women who receive chemotherapy or undergo surgery to remove their ovaries will experience hot flashes.
Scientists know that hot flashes occur as a result of low estrogen levels. Each hot flash involves a sensation of heat that starts in the chest area and travels to the neck and the head. It can last for a few minutes and may cause sweating. Some women also develop a faster heart rate during hot flashes.
If a hot flash happens during sleep, they are called night sweats. Women who have night sweats often wake up in the morning feeling tired.
Some people experience redness along their neck and face during a hot flash. This is called a hot flush.
On average, each hot flash lasts for about three to four minutes. Hot flashes can occur for a few months to several years. In a few rare cases, some people had hot flashes for 10 years.
Other signs of hormonal imbalance include:
- Heavy or irregular periods, missed periods, frequent periods, or stopped periods
- Vaginal dryness and itching
- Weakened muscles
- Pain in the muscles, tenderness, and stiffness
- Pain and swelling in the joints
- Cancer treatments
What Are The Symptoms Of Heavy Or Irregular Periods
The length of the menstrual cycle and amount of blood flow is unique to each woman. However, most women have a cycle that ranges from 24 to 34 days.
Blood flow averages about four or five days, with a blood loss of about 40 cc . Its important to remember that these are just averages. Your normal may fall outside of these ranges. A blood loss of 80 cc or more is considered an abnormally heavy flow.
Signs that your menstrual flow may be abnormally heavy include:
- soaking through more than one tampon or sanitary pad in an hour for several hours at a time
- waking up during the night because you need to change protection
- passing large blood clots in your menstrual flow
- experiencing a menstrual flow that lasts more than a week
Also, an abnormally heavy flow can cause you to experience the following symptoms, which may be an indication of anemia:
- shortness of breath
While every womans cycle is different, irregularities such as bleeding mid-cycle or bleeding after intercourse are abnormal symptoms.
You should see your gynecologist regularly for a checkup. However, make an appointment right away if you have bleeding or spotting in the following circumstances:
- between periods
Keep track of your menstrual cycles, including how long your blood flow lasts, and how many tampons or sanitary pads you use during each cycle. This information will be helpful at your gynecological appointment.
Avoid products that contain aspirin because they may increase bleeding.
How Is Abnormal Uterine Bleeding Diagnosed
The tests your doctor orders may depend on your age. If you could be pregnant, your doctor may order a pregnancy test. If your bleeding is heavy, in addition to other tests, your doctor may want to check your blood count to make sure you dont have a low blood count from the blood loss. This could lead to iron deficiency and anemia.
An ultrasound exam of your pelvic area shows both the uterus and the ovaries. It may also show the cause of your bleeding.
Your doctor may want to do an endometrial biopsy. This is a test of the uterine lining. Its done by putting a thin plastic tube into your uterus. Your doctor will use the catheter to remove a tiny piece of the uterine lining. He or she will send that lining to the lab for testing. The test will show if you have cancer or a change in the cells. A biopsy can be done in the doctors office and causes only mild pain.
Another test is a hysteroscopy. A thin tube with a tiny camera in it is put into your uterus. The camera lets your doctor see the inside of your uterus. If anything abnormal shows up, your doctor can get tissue for a biopsy.
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What You Can Do To Ease Heavy Periods
First things first, its critical to assess for and address underlying medical conditions. If youre experiencing new onset of heavy menstrual bleeding pain, fever, unpleasant-smelling vaginal discharge, or any other new or unusual symptoms its really important to see your medical provider and rule out a more serious medical condition like a pelvic infection, endometrial cancer. Heavy bleeding can also be due to a miscarriage, which may sometimes require medical attention.
I also recommend getting checked for iron deficiency anemia if you have low energy, fatigue, low mood, or difficulty focusing around your period. Anemia can result from heavy blood thats significant enough to require support. More severe anemia can also cause other symptoms such as breathing difficulties and a racing heart, particularly following strenuous physical activity. Getting your iron levels back to a normal level can make a world of difference in how you feel, even without any other interventions.
While most causes of heavy periods are benign or treatable with natural therapies, its important not to wait to get appropriate medical care.
Assuming more serious medical conditions have been ruled out, your symptoms have been going on for a long time, and youre ready to roll up your sleeves and try natural approaches, an integrative approach to heavy periods is a reasonable next step.
Take an Integrative Medicine Approach
Common Causes Of Heavy Menstruation
Heavy menstrual bleeding is frustrating and disruptive, but not uncommon. Typically, your period lasts about 5-7 days, but if you have heavy bleeding, it may last longer.
Heavy menstrual bleeding also means you may need to change your hygiene product often every hour or two. You may pass clots of blood the size of a quarter, or larger.
At Capital Womens Care, we dont want you to suffer heavy menstrual bleeding if you dont have to. Heavy bleeding is not just inconvenient, it can lead to anemia and be accompanied by abdominal pain and emotional distress.
Our OB/GYN team does its best to identify why you have heavy menstrual bleeding and offer the best treatment possible.
Learn more about three of the most common causes we look for.
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Why Is My Period Suddenly Heavy This Month
Its common for a cycle to be heavier than usual now and then. But if it seems very different from how it usually is, you may want to call your doctor to rule out any underlying causes. If you are sexually active, take a pregnancy test, since a miscarriage or ectopic pregnancy can lead to heavy bleeding and pain and be life-threatening.
Another reason for your period to suddenly be heavier is if you started, switched, or stopped birth control. Taking a blood thinner, even aspirin or ibuprofen, may cause a heavier period. Infections of the uterus, including sexually transmitted infections , can also cause an abnormally heavy menstrual flow.
How Do You Know If You Have Heavy Periods
First things first how do you know if you have a heavy period? Normal period blood loss is considered 30-80 mL, approximately 1-6 tablespoons. But what does that really mean?
Here are the most common signs that your period is truly heavy:
- Your period lasts longer than 7 days.
- You need to use more than 6 pads or tampons per day, not fully soaked, or youre soaking through more than two pads or tampons in a day.
- You typically need to change your pads or tampons after only 1 or 2 hours.
- Youre regularly soaking through your clothes on your period, or youre having to double up on pads so you dont.
- You have to change your tampon or pad during the night.
- Youre passing blood clots the size of a quarter or larger with your period blood.
- Youre having to plan your activities around your period.
If you consistently have a heavy period, you may also find yourself feeling weak, tired and sluggish during the day, which can be a sign of iron deficiency anemia due to a consistently heavy period.
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Birth Control And Certain Medication
Some drugs, notably blood thinners, might cause heavy periods. Changes in your birth control, for instance, the use of a copper or hormonal intrauterine device can result in heavier periods for three to six months following installation.
It often takes a few months for your body to adjust. After a short-term adjustment period, your menstrual flow should lighten. If you notice changes to your period after starting a new drug or method of birth control, consult your doctor.
Causes Of Heavy Menstrual Bleeding
How do you know when your period is normal and when its not? Menstrual bleeding is different for every woman and can change as you age. There might be days when you have a heavy flow and cramps, which is completely normal. But if you have heavy bleeding that interferes with daily activities, you could have a condition called menorrhagia, or heavy menstrual bleeding.
Heavy menstrual bleeding can be caused by subtle health problems that can go unnoticed. In some cases, a larger health issue is the problem. For instance, endometriosis can cause painful and heavy periods. March is Endometriosis Awareness Month, so now is a good time to get familiar with its symptoms.
If you experience heavy menstrual bleeding, it might be time to talk to your doctor. Your doctor will ask you about your health history, perform a physical exam and may order tests like an ultrasound, Pap test or blood tests. After your doctor rules out other potential health problems, they may be able to diagnose you with menorrhagia.
Signs and symptoms of menorrhagia may include:
- Soaking through one or more sanitary pads or tampons every hour for several hours
- Waking up in the middle of the night to change their sanitary pads
- Using two sanitary pads to manage heavy menstrual bleeding
- Bleeding longer than a week
- Passing blood clots larger than a quarter
- Restricting daily activities due to heavy menstrual bleeding
- Symptoms of anemia, tiredness, fatigue, and shortness of breath
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How Is Menorrhagia Diagnosed
Diagnosing menorrhagia has two parts: confirming that your bleeding is unusually heavy, and identifying the underlying cause.
For the first part, your doctor will ask you questions about your medical and menstrual histories. For the second part, one or more tests may be used. Examples include:
- A blood test to check hormone levels and look for signs of anemia or clotting issues.
- A Pap test, where cells from your cervix are examined for signs of infection, inflammation or other unusual changes.
- An endometrial biopsy, which involves taking samples from your uterine lining. The samples are looked at to see if any unusual or cancerous cells are present.
- An ultrasound, which uses sound waves to check for dysfunction in the pelvic organs, as well as blood flow issues.
- A sonohysterogram, another kind of ultrasound thats done while your uterus is filled with liquid to get a better look at the uterine lining.
- A hysteroscopy, where a very small, flexible camera is used to examine the uterus for fibroids, polyps and other possible causes of bleeding issues.
How Can I Stop Heavy Periods
Knowing the underlying reason for your heavy periods is key to getting the treatment that will be most effective for you, which is why talking to a doctor is so important. In some cases, heavy periods caused by fibroids, growths or endometriosis are best treated through surgery. But most often, menorrhagia treatment is a matter of lifestyle changes and medication, such as:
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How To Balance Hormones Causing Irregular Periods
While there are lifestyle changes you can make that can help regulate your hormones, its best to see a doctor if youre having symptoms of hormone imbalance or if your periods are irregular.
They will be able to monitor hormone levels and make sure theyre where they need to be. They can also determine whether or not treatments are working.
Depending on the underlying cause of the hormone imbalance or which hormones are irregular, other treatments might also be used.
Immaturity Of The Hypothalamic
What is immaturity of the hypothalamic-pituitary-ovarian axis?
In the 2-3 years that follow the first period, many adolescent girls experience irregular periods. Sometimes this comes in the form of missed or very light periods, while others may experience heavy menstrual bleeding . The menstrual cycle is controlled by complex interactions between the hypothalamus, the pituitary gland, and the ovaries . This system takes time to mature, and when it is not functioning properly, ovulation may not occur. When ovulation does not happen, there is no progesterone present in the uterus, and the lining of the uterus becomes very thick and contain more blood vessels than usual. This can result in a heavy and prolonged period. This is one of the most common cause of HMB in adolescents.
What causes immaturity of the hypothalamic-pituitary-ovarian axis?
It is not known why the hormonal regulation of the menstrual period is sometimes slower to develop.
What are the symptoms of an immature hypothalamic-pituitary-ovarian axis?
You may have irregular periods or skip a period. Or, you may have HMB. The HMB associated with immaturity of the hypothalamic-pituitary-ovarian axis is not different from other causes of HMB. This means you have any of the following:
How is immaturity of the hypothalamic-pituitary-ovarian axis diagnosed?
How is immaturity of the hypothalamic-pituitary-ovarian axis treated?
How Is A Hormonal Imbalance Diagnosed
First, make an appointment with a health care provider for a physical exam. The health care provider will ask about your symptoms. Then, depending on your symptoms, they will suggest which hormone imbalance tests to do. These could be evaluations like:
- Blood test: Estrogen, progesterone, testosterone, thyroxine, TTH, insulin, and cortisol levels can be detected in the blood.
- Pelvic exam: A health care provider will search for any lumps or cysts.
- Ultrasound: Images of your uterus, ovaries, thyroid, and pituitary gland can be obtained.
Can I Figure Out How Much Im Bleeding
The easiest way, knowing that one soaked, normal-sized sanitary product holds about a teaspoon of blood loss. Keeping the Menstrual Cycle Diary or Daily Perimenopause Diary is a convenient way to assess the amount and timing of flow using either a count of soaked regular sized sanitary products or a measuring menstrual cup. . To accurately record the number of soaked sanitary products each day you need to recall the number you changed that were half full and multiply that to give the number of fully soaked ones. A maxi or super tampon or pad holds about two teaspoons or 10ml of bloodtherefore record each larger soaked sanitary product as a 2. In addition, record your best judgment about the amount of flow where a 1 is spotting, 2 means normal flow, 3 is slightly heavy and 4 is very heavy with flooding and/or clots. If the number of soaked sanitary products totals 16 or more or if you are recording 4s you have very heavy flow. To measure your flow using a menstrual cup with measurements, just add up the approximate amounts from each time you emptied it and record on the “# of pads/tampons” line.
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Treatment Of Heavy Menstrual Bleeding
At Childrens Hospital of Philadelphia, adolescent medicine specialists are able to manage the majority of cases of heavy menstrual bleeding. However, if necessary, a coordinated approach may be used with specialists from gynecology, hematology, radiology and endocrinology and others to accurately diagnose and treat patients with heavy menstrual bleeding.
Treatment for heavy menstrual bleeding will be recommended by your adolescent’s physician based on:
- Your adolescent’s age, overall health and medical history
- Cause and severity of the condition
- Your adolescent’s tolerance for specific medications, procedures or therapies
- Your adolescents future childbearing plans
- Effects of the condition on your adolescents lifestyle
- Your adolescent’s opinion or preference
What Is A Hormonal Imbalance
Hormones are chemicals produced by different glands and tissues, forming a part of the endocrine system.
Hormones travel to all of the bodys tissues and organs through the bloodstream. They give messages to these organs, letting them know what function to perform and when to do it.
Hormones help regulate a lot of processes in the body. Hormones manage appetite and metabolism, sleep cycles, heart rate, sexual function, general mood and stress levels, and body temperature. Because they affect so many functions, imbalances in certain hormones can lead to uncomfortable symptoms.
A hormonal imbalance occurs when a person has too much or too little of a certain hormone, such as insulin, cortisol, thyroxine, androgens, estrogen, or progesterone. Even slight changes can have a significant effect on your body.
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Questions To Ask Your Doctor
- What is the likely cause of my abnormal uterine bleeding?
- Is my condition serious? Am I at risk for any other health problems?
- Based on the cause, what treatment options do you recommend?
- What are the risks and benefits of this treatment?
- Will the treatment affect my chances of getting pregnant in the future?
Frequently Asked Questionsexpand All
- How common is heavy menstrual bleeding?
Heavy menstrual bleeding is very common. About one third of women seek treatment for it. Heavy menstrual bleeding is not normal. It can disrupt your life and may be a sign of a more serious health problem. If you are worried that your menstrual bleeding is too heavy, tell your obstetriciangynecologist .
- When is menstrual bleeding considered heavy?
Any of the following can be a sign of heavy menstrual bleeding:
Bleeding that lasts more than 7 days.
Bleeding that soaks through one or more tampons or pads every hour for several hours in a row.
Needing to wear more than one pad at a time to control menstrual flow.
Needing to change pads or tampons during the night.
Menstrual flow with blood clots that are as big as a quarter or larger.
Heavy menstrual bleeding may be a sign of an underlying health problem that needs treatment. Blood loss from heavy periods also can lead to a condition called iron-deficiency anemia. Severe anemia can cause shortness of breath and increase the risk of heart problems.
Many things can cause heavy menstrual bleeding. Some of the causes include the following:
Bleeding disordersWhen the blood does not clot properly, it can cause heavy bleeding.
When you see your ob-gyn about heavy menstrual bleeding, you may be asked about
past and present illnesses and surgical procedures
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