Intense periods can be truly annoying. Who doesn’t love piercing cramps, erratic poops, and doubling on pads? But when you have uterine fibroids—benign, noncancerous growths or tumors that form in your uterus—a heavy flow might be more than just an inconvenience. It’s sometimes really uncomfortable and even painful, and it can disrupt your life.
Stephanie Hack, MD, FACOG, who specializes in reproductive health advocacy, tells SELF that “heavy bleeding” used to be defined by the amount of blood a person with a uterus expels during their period: roughly 16 teaspoons, or one-third of a cup, per day. While that’s still one indication, there are other potential tells: Bleeding that lasts more than seven days, or having to wear multiple pads at once or both a tampon and pad also signal an abnormal flow, per the American College of Obstetricians and Gynecologists. Your happiness is a major factor too: “Now, we consider excessive bleeding [an amount] that affects the quality of life,” Dr. Hack says.
Major menstrual bleeding occurs when a person has uterine fibroids because they “increase the surface area of the inner lining of the uterus, which allows for more blood loss,” Dr. Hack explains, adding that fibroids can also affect your uterus’s ability to contract, or place pressure on the endometrium (a.k.a. the tissue that lines your uterus). Size and amount matter too: The larger your fibroids are, and the more of them you have, the higher your chance for a strong flow, Christine Armstrong, MD, an ob-gyn practicing in Waterbury, Connecticut, tells SELF. “However, heavy bleeding can still occur with one small fibroid.”1
In some cases, heavy bleeding can lead to health complications like anemia—so treating uterine fibroids is important. The best option for you, Dr. Hack says, will depend on your symptoms, health history, and future pregnancy plans. Here are a few options you may want to discuss with an ob-gyn.
While no food will eliminate fibroids (or the heavy periods they might cause), some might help minimize your symptoms, Dr. Wetter notes. In a 2021 review of studies on uterine fibroids,2 people with uteruses who regularly consumed fruits, vegetables, and foods with vitamin D, like milk, yogurt, salmon, and tuna—were at a reduced risk of developing fibroids.
“We think these foods are helpful because they may help your body eliminate excess estrogen with high fiber content, while antioxidants may help fight fibroid growth,” Dr. Wetter says. Containing foods that contain iron can help treat anemic symptoms from heavy bleeding, Dr. Hack says. Some research also suggests that exercise may decrease fibroid symptoms, including heavy bleeding.3
While Dr. Wetter says nutrient-rich foods and regular movement can help manage symptoms, they aren’t an be-all, end-all solution: “I recommend making those changes, but to also consider medication or other management as diet and lifestyle changes may not be enough depending on the severity of the bleeding.”
Over-the-counter and prescription medications
Though they don’t eliminate fibroids, some medications can help manage heavy bleeding and other period symptoms, like cramps. Hormonal prescriptions are a popular option, Amy Wetter, MD, a board-certified ob-gyn at Pediatrix Medical Group in Atlanta tells SELF. They help reduce estrogen and progesterone, which are responsible for stimulating fibroid growth. A doctor might prescribe a gonadotropin-releasing hormone (GnRH) or a GnRH antagonist, but hormonal birth control, like birth control pills, also works this way.
Intrauterine devices (IUDs) are also sometimes prescribed for heavy bleeding, but not in all cases: “[IUDs are] not an option if the fibroid causing bleeding is in the cavity of the uterus, which would prevent proper insertion or placement,” Dr. Wetter says.
Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) are an accessible and low-cost option, according to Dr. Wetter. “When taken [a] day before [your period starts], and then for the first few days of your menses, these will significantly lessen bleeding and cramps,” she says. Other prescriptions, like antifibrinolytic medications, can be beneficial if you have blood clots. “This [type of] medicine can stop blood clots from breaking down,” Dr. Wetter explains.
Noninvasive or minimally invasive procedures
If you can find relief from heavy bleeding by taking medications, that’s often the best scenario, Dr. Wetter says. But if you’ve been taking a prescription or over-the-counter solution with no success, you might want to think about a noninvasive or minimally invasive treatment, which are procedures that only require small incisions and a few stitches. That means you’re likely to go about your life normally not long after a given procedure is done.
Just because a treatment is noninvasive doesn’t mean it’s free from side effects. Endometrial ablation, for example, uses things like extreme temperatures and electric currents to remove the inner uterus lining. It can sometimes cause infertility—so consider whether you want to get pregnant in the future before you choose it.
Other nonsurgical treatments include the following, per Dr. Wetter:
- Focused ultrasound procedure: A doctor uses high-energy, high-frequency sound waves to remove fibroids while you’re inside an MRI machine.
- Hysteroscopic myomectomy: If your fibroids bulge into your uterine cavity (called submucosal fibroids), this treatment—where fibroids are removed from the uterus with a camera and small instruments—can be effective.
- Uterine fibroid embolization: Tiny particles are injected into blood vessels that “feed” the fibroids through a catheter, causing the fibroids to shrink over the next few weeks and months.
Most often, treating heavy uterine fibroid bleeding takes some trial and error—you might find some methods work better than others. But maybe you’ve tried all of the above, are still having disruptively heavy periods, and need to undergo a more serious procedure. Or maybe uterine fibroids mean your periods are particularly extreme to the point that they call for intensive treatment sooner than another person’s might: According to Dr. Hack, if you’re unable to work, care for yourself or others, or exercise due to your periods, you might skip minimally or noninvasive treatments and go straight for surgery.
When a person receives surgery for uterine fibroids, it’s either an abdominal or laparoscopic myomectomy (when surgery is performed on the uterus, which stays intact) or a hysterectomy (when the uterus is removed entirely). Dr. Wetter says a myomectomy may be ideal if you want to become pregnant in the future, or are still on the fence about it. A hysterectomy, which is often a permanent solution to uterine fibroid symptoms including agonizing periods, makes a person unable to get pregnant.
How to choose the right solution for you
Just as no two uterine fibroid cases are the same, no single treatment for heavy bleeding is ideal. Finding the best solution will require “a conversation with shared decision-making with you and a doctor,” says Dr. Wetter. This means you need to really consider how strong your symptoms are and whether you’re ready to take on more invasive (or permanent) methods—which, though they can come with big decisions, can also offer great relief.
Uterine fibroids and super-heavy bleeding can disrupt your life. But there are treatment options that can help you reclaim your well-being—and feel much better. Talk to a doctor if you think that sounds like a huge relief: The two of you can work together to make your period less of a nightmare and help you get on with your day.
- Frontiers in Reproductive Health, Uterine Fibroids (Leiomyomata) and Heavy Menstrual Bleeding
- International Journal of Environmental Research and Public Health, Uterine Fibroids and Diet
- American Journal of Epidemiology, Association of Physical Activity with Development of Uterine Leiomyoma