It is common for periods to last between 3-7 days, so having a heavy flow for 3 days is generally considered normal. However, heavy menstrual bleeding that meets certain criteria is diagnosed as menorrhagia or abnormal uterine bleeding (AUB).
What is considered a heavy period?
Heavy periods are subjective, but some signs of an abnormally heavy flow include:
- Bleeding through a pad or tampon every 1-2 hours
- Passing large blood clots (larger than a quarter)
- Waking up to change pads/tampons during the night
- Bleeding that lasts longer than 7 days
- Low energy and fatigue from excessive blood loss
A heavy flow alone does not necessarily mean something is wrong. But if it interferes with your daily life, see your doctor.
When is a 3-day heavy period considered abnormal?
Menorrhagia is defined as excessive bleeding during periods, either in frequency or quantity. To be diagnosed with menorrhagia, you typically need one or more of the following:
- Bleeding lasting longer than 7 days
- Losing more than 80ml of blood per cycle
- Periods that frequently have large clots
- A menstrual flow heavy enough to interfere with normal activities
So if you have heavy bleeding that meets the above criteria for 3 or more days, it would be considered abnormal and should be evaluated by your doctor.
What causes heavy periods?
Some common causes of heavy menstrual bleeding include:
- Hormonal imbalances – Issues with hormones like estrogen can impact menstrual flow.
- Uterine fibroids – Noncancerous growths in the uterus that can make periods heavier.
- Adenomyosis – A condition where the uterine lining grows into the muscular wall of the uterus.
- Polyps – Small, benign growths attached to the uterine lining.
- Intrauterine devices (IUDs) – Some IUDs can initially cause heavier bleeding and cramping.
- Pregnancy complications – Miscarriages or ectopic pregnancies may cause heavy bleeding.
- Clotting disorders – Problems with blood clotting can lead to heavy periods.
There are also other medical conditions, like thyroid disorders and liver or kidney disease, that can sometimes impact menstrual flow.
When to see a doctor
You should make an appointment with your doctor if:
- Your period lasts longer than 7 days
- You are soaking through a pad or tampon every 1-2 hours
- You pass large clots or double your normal amount of menstrual flow
- Your periods are impacting your ability to do normal daily activities
- You suddenly start having much heavier periods than usual
- You have periods more often than every 21-35 days
- You experience symptoms like weakness, fatigue, or shortness of breath
Evaluation of heavy periods involves obtaining a detailed history, physical exam, and sometimes blood tests or imaging studies. Your doctor can help determine if your heavy flow is normal or requires treatment.
Treatment for heavy periods
Treatment depends on the underlying cause but may include:
- Hormonal birth control – Methods like the pill, patch, ring, shot can lighten menstrual flow.
- NSAIDs – Non-steroidal anti-inflammatories like ibuprofen or naproxen sodium can reduce heavy bleeding.
- Tranexamic acid – This non-hormonal medication helps prevent excessive blood loss.
- Desmopressin – This hormone helps blood clot and is used for bleeding disorders.
- Endometrial ablation – A procedure that destroys the uterine lining to reduce menstrual flow.
- Uterine artery embolization – Blocking blood flow to fibroids to shrink them.
- Surgery – Removal of fibroids, polyps, or even hysterectomy may be options.
Making lifestyle changes like avoiding NSAIDs, exercising regularly, maintaining a healthy weight, and reducing stress can help as well.
When to see a doctor immediately
Very heavy bleeding can sometimes lead to anemia from too much blood loss. Seek emergency care if you have:
- Dizziness, lightheadedness, chest pain, rapid heart rate
- Shortness of breath
- Fatigue, confusion, or weakness
- Blood clots larger than a lemon
- Bleeding that completely soaks 1 pad/tampon per hour for multiple hours
These can be signs of iron deficiency anemia from excessive menstrual bleeding and may require IV fluids or blood transfusion.
Conclusion
Having heavy periods for 3 days can be normal for some women. But excessive menstrual bleeding that interferes with your daily life or meets the criteria for menorrhagia should be evaluated by your doctor. Treatments like hormonal birth control, medications, ablation, or hysterectomy can provide relief from heavy periods when needed.