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How to Manage Severe Menstrual Pain and Heavy Bleeding

How to Manage Severe Menstrual Pain and Heavy Bleeding

Most women have a regular menstrual cycle which means that month after month, for 4 to 7 days on average, they will undergo menstruation. For some, this will be nothing but mild discomfort. But for other women, this time of the month means severe menstrual pain and heavy bleeding that renders them unable to go about their daily lives.

If this has happened to you, here’s everything you need to know about severe menstrual pain and heavy bleeding.

What Characterizes Severe Menstrual Pain?

Severe menstrual pain is caused by uterine contractions.

This can happen before or during the onset of your period.

Most cramps feel like an incessant pain in your lower abdomen. Sometimes, it can feel like semi-heavy pressure or a dull ache, with pain that radiates to your lower back and inner thighs. This pain normally lasts for two to three days.

Severe cramps, however, tend to begin earlier and last longer. Over-the-counter medication doesn’t lessen the pain and unlike regular menstruation, severe menstrual pain is normally accompanied by heavy bleeding or clotting.


The medical term for menstrual pain is dysmenorrhea. There are two known types: primary and secondary.

  • Primary dysmenorrhea is ordinary menstrual cramps. This can sometimes be accompanied by fatigue, diarrhea, and vomiting. This becomes less painful as you get older and may even stop once you have a baby.
  • Secondary dysmenorrhea is more serious, as this is caused by a disorder in the reproductive organ. This is normally associated more with severe menstrual pain and heavy bleeding.


The medical term for menstruation with heavy or prolonged bleeding is menorrhagia. This normally lasts more than 7 days.

Normally, women lose an average of 30 to 40 milliliters of blood (or around 6 to 8 teaspoons of blood) during their menstrual cycle. Women who experience menorrhagia may lose more than 80 milliliters, which is more than the normal amount. This may cause anemia, which can lead to dizziness or fatigue.

If you experience any of the following symptoms, you may have menorrhagia:

  • Using double sanitary protection due to extremely heavy flow
  • Changing pads on an almost hourly basis because it fills up easily
  • Waking up in the middle of the night to change pads
  • Bleeding for more than a week
  • Blood clots that are bigger than a coin
  • Not being able to do your normal routine due to heavy flow
  • Tiredness, fatigue, and shortness of breath

What causes severe menstrual pain and heavy bleeding?

Uterine contractions, which can result in menstrual cramps, can be caused by prostaglandins which are hormone-like substances. Though not yet proven, it has been shown that the higher the level of prostaglandins, the more severe the menstrual cramp can be.

There are other possible causes for experiencing extreme menstrual pain and heavy, prolonged bleeding. Here’s a list of potential reasons:

  • Using an Intrauterine Device (IUD) as a form of birth control
  • Ovarian cysts
  • Uterine fibroids or polyps
  • Adenomyosis
  • Endometriosis
  • Pelvic infections

Other potential reasons are:

  • Ectopic pregnancy
  • Cancer of the uterus or cervix
  • Von Willebrand Disease

Who is at risk of having severe menstrual pain and heavy bleeding?

There are certain people who may be more prone to experiencing severe menstrual pain though not everyone who falls under these categories will.

  • Irregular menstrual cycle
  • Family history of excessively painful periods
  • Never having given birth
  • Being 30 years old and below
  • Smoking

Treatment for severe menstrual pain and heavy bleeding

When severe menstrual pain and bleeding starts to affect your daily life, your doctor may give you options to control this. The treatment that will be recommended will be based on the severity of the situation.

You can be given birth control pills to alter the balance of hormones in your body to end heavy periods. Or you can be prescribed medications to reduce heavy flow.

As a last resort, you can also be recommended for surgery if needed to remove fibroids or polyps if this is the cause of the severe menstrual pain and bleeding.

In really extreme cases, doctors would recommend a hysterectomy, which is a surgery to remove the uterus.

When is it time to call a doctor?

For some women who have high tolerance, severe menstrual pain and heavy bleeding may be a normal occurrence, but if you experience the following symptoms, it’s time to book that appointment with your OB-GYN.

  • 3 painful menstrual cycles
  • Presence of blood clots
  • Pelvic pain even when not menstruating
  • Pain that persists even after IUD placement
  • Cramping that is accompanied by nausea and diarrhea

Key Takeaways

Even though having severe menstrual pain and heavy bleeding month after month can be a major inconvenience, this should not hinder you from enjoying life.

As long as you follow what the doctor will prescribe and suggest, you should be able to go about your daily routine. There are medicines that are available to help ease the pain and regulate your cycle so that you can still enjoy life even during that time of the month.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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Written by Kathy Kenny Ylaya Ngo Updated May 24, 2020
Medically reviewed by Jobelle Ann Dela Cruz Bigalbal, M.D.