Do Heavy And Prolonged Periods Impact Your Fertility?

Menorrhagia — Heavy And Prolonged Periods

Heavy and prolonged periods that follow a regular cycle are medically referred to as menorrhagia. Every individual woman's menstrual cycle is different, and the same goes for the length of menstrual flow itself. It is still possible to say that a normal, average menstrual cycle lasts somewhere between 24 and 32 days. Most women bleed between four and six days during most cycles. Your typical woman will lose between 25 and 80 ml of menstrual fluids during any given cycle.

Those suffering from menorrhagia experience periods that are longer and heavier than normal. If a woman's menstrual bleeding continues beyond seven days during a typical cycle and she loses more than 80 ml of blood and related fluids, she meets the conditions to be diagnosed with menorrhagia, in other words heavy and prolonged periods.[1]

Unfortunately, menorrhagia is coupled with dysmenorrhea, unusually painful periods, quite frequently. A menorrhagia diagnosis requires the woman to still have her periods at regular and predictable intervals; those who also have more frequent or unpredictable periods will get another diagnosis, such as menometrorrhagia.

Do you recognize yourself in this? Any woman who has periods “from hell” that she dreads on a monthly basis should absolutely seek care. You should see your family doctor or OBGYN whether you think your period is unusually long, abnormally heavy, or very painful.

If your periods are so bad that you regularly take time off work or other activities, speedily seeing your healthcare provider is strongly recommended. You should see your doctor because you deserve treatment for highly unpleasant menstrual periods, but also because these periods could point to another medical problem.

Many women wonder how they can be sure their period is unusually heavy. Most doctors don't actually measure the quantity of blood loss you experience, but with a reusable menstrual cup such as the Diva Cup, that is possible. Soaking through several menstrual pads or tampons within an hour, and needing to change your menstrual pads or tampons a few times at night too are good indications that you have really heavy bleeding.

There is a long list of possible causes of heavy and prolonged menstrual bleeding. We'll go through some of them now, but I'll stress that this is for informative purposes only. You need to see a doctor for diagnosis — and should not be tempted to ignore your horrible periods, as you will conclude yourself after seeing what can cause them.

In the next section, I'll go through the possible causes of heavy and prolonged periods. I'll discuss whether a particular cause can negatively impact your fertility. In short, the answer to the question whether heavy and prolonged periods could indicate a fertility problem is yes. In some cases, menorrhagia is caused by a problem that can also make you infertile. This is only one reason to take quick action. 

Menorrhagia Causes And How They Affect Your Fertility

The Copper T

Those women who have been fitted with a copper intrauterine device as their chosen form of birth control will experience menorrhagia. If you are using the Paragard, you probably don't need to be worried about heavy and prolonged bleeding. You could, however, consider alternative birth control options.[2]

The Mirena hormonal intrauterine device is another highly effective birth control choice. Unlike the copper T, the Mirena usually actually decreases menstrual bleeding. If an IUD is the culprit, removing it can take away both the nasty periods and your inability to get pregnant. But you had figured that one out already![3]

Use Of Medication

Certain medications can lead to heavy and prolonged periods, like anticoagulants and anti-inflammatory drugs. If you are using any medications, check with your doctor to see if they could be behind your menorrhagia and explore alternative options.[3, 4]

Hormonal Imbalance

Hormonal imbalances are a common cause of menorrhagia. Estrogen and progesterone are the two hormones that regulate the formation of the uterine lining (endometrium), though many other hormones are involved in the regulation of the menstrual cycle. An imbalance can lead to the overgrowth of the endometrium, thus causing heavy and prolonged menstrual flow. The same hormonal imbalance can can prevent ovulation from occurring as well. A hormonal imbalance is a very common cause of female infertility. Thankfully, it can often be treated with medications.[1]

Uterine Fibroids And Polyps

Fibroids are another possible reason for heavy and prolonged periods. Fibroids can be as tiny as a pea, or as large as an orange. Uterine fibroids are extremely common, occurring in up to 40 percent of all women of reproductive age. The good news is that they don't often lead to fertility problems. Some types of uterine fibroids are associated with infertility or an increased risk of miscarriage, however. 

The mechanism of uterine fibroids effect on menorrhagia is poorly understood but researchers connect it to abnormalities of local venous drainage, enlargement of the uterine cavity and abnormalities in prostaglandin production.[5] 

Polyps, small uterine growths, can also lead to menorrhagia, and these can cause fertility problems too. Both fibroids and polyps can be removed surgically.

Adenomyosis And Endometriosis

The muscular wall of the uterus is affected by the growth of endometrial tissues in women with adenomyosis. This condition has some things in common with the more well-known endometriosis, in which the uterine lining grows outside the uterus, in the fallopian tubes and ovaries for example. It is not, at present, quite clear whether adenomyosis causes infertility, but researchers strongly suspect that it does. They also hope that the introduction of MR and, even more, that of the more readily available 3D-TVS will facilitate early diagnosis of  the condition. Adenomyosis is more common in women from their late thirties, and those women have a higher chance of infertility already.

Endometriosis can cause heavy and prolonged periods as well, but less rarely so. This condition is also likely to lead to other more clearly associated symptoms — notably painful periods (dysmenorrhea), general abdominal pain, and pain during intercourse and bowel movements. Another endometriosis symptom is, unfortunately, infertility.  Typically, endometriosis causes pain and infertility, although up to 25% of patients are asymptomatic.[6] 

Now, we've covered the most common reasons women experience heavy and painful periods. They are not, however, the only menorrhagia causes. Rarer causes include cancer (uterine, cervical or ovarian), some blood clotting disorders, and even Pelvic Inflammatory Disease. If your monthly period is more like a monthly blood bath, I am sure I don't have to remind you again: See your doctor, as soon as possible.