20 Reasons for Heavy Painful Periods
There are many reasons for heavy painful periods. While period cramps and heaviness are definitely common, that doesn’t mean that they are normal. Any sort of pain is a sign from your body to investigate an imbalance in the body.
Endometriosis is an extreme case of period pain and requires a medical diagnosis. This condition has life-disrupting period pain and heaviness characterized by a growth of uterine tissue somewhere else in the body.
A heavy period consists of...
1. A period lasting longer than 7 days
2. Losing more than 80 mL of blood per cycle (or 16 regular tampons or pads)
3. Changing tampons or pads every hour or two
4. Needing to double up on period protection products
5. Having to wake up to change your tampon or pad in the night
6. Planning activities around your heavy period
7. Blood clots the size of a quarter or bigger
Here are X reasons for heavy painful periods:
1. PROSTAGLANDINS
Prostaglandins are one of the reasons for heavy painful periods. Prostaglandins are sex hormones that work in opposition with progesterone, so when progesterone decreases right before menstruation, then prostaglandin will increase. Their function is to cause the uterus to contract to shed the lining. During labor, these contractions help to push out the fetus, but otherwise, these contractions are what we consider cramps. Prostaglandins are involved in pain and inflammation. High levels of prostaglandins can mean more severe pain. When prostaglandins are high then progesterone levels are low, and this causes an imbalance between progesterone and estrogen which results in other common painful symptoms like breast tenderness, headaches, nausea, and fatigue.
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2. HIGH ESTROGEN
High estrogen levels are another reason for heavy painful periods. Heavy bleeding can be caused by polyps which occur when there is enlarged tissue growth in the endometrial cavity. Estrogen functions to build up the endometrial wall for menstruation, so when estrogen levels are high then heavy painful periods can occur. High estrogen also causes more pain because prostaglandins will be higher.
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3. LOW PROGESTERONE
Another one of the reasons for heavy painful periods is low progesterone. In a normal period, after ovulation, the egg is released from the follicle and the resulting sac called the corpus luteum will secrete progesterone. In anovulation, the egg is not released and the corpus luteum will not produce progesterone, resulting in lower circulating progesterone levels. In addition, due to lower progesterone, this can lead to higher estrogen in the body and results in heavy periods.
3. POOR ESTROGEN DETOXIFICATION
Another reason for heavy painful periods is poor estrogen detoxification. High estrogen is a promoter of period pain, so if you have a poor ability to detoxify or eliminate the estrogen, it will recirculate in the body and increase total estrogen levels. Higher estrogen can lead to estrogen dominance which is an imbalanced ratio of too much estrogen compared to progesterone. Detoxification of estrogen is a normal process that our liver, kidneys, and digestive system should be doing independently, but these processes can slow down and not function right due to several reasons. There are 3 main steps to the detoxification process that must happen to eliminate the estrogen. First, the estrogen is converted into another compound, next, that compound is packaged up with the help of a nutrient like amino acid, and finally, that new compound is excreted from the body.
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4. GUT ISSUES
Gut issues are another reason for heavy pain composed of a variety of different bacteria that aid digestion and are fueled by fiber. This bacteria is good, and we want a broad diversity of it to digest foods. Gut issues or (gut dysbiosis) is when there is an imbalance in the amount of these bacteria microorganisms in the intestines. This imbalance of bacteria is what causes period pain because the gut regulates estrogen through an enzyme that converts it into its active form for elimination, but when this process doesn’t work, you can get an increase in recirculated estrogen. When the gut bacteria is not in balance, this process can be defective, which slows the digestion process and leads to higher estrogen levels which is why gut issues are one of the reasons for period pain.
Source: 28778332
5. STRESS
Another reason for heavy painful periods is stress. Stress is a response in our body that occurs when there is a mild or severe threat. This stress response makes us produce higher levels of cortisol, a stress hormone, from the adrenal glands. Since it is a hormone, if you have elevated levels of cortisol, this will imbalance estrogen and progesterone levels. As a result, stress can make period pain worse because it will promote the inflammatory response and will also deregulate the hypothalamic-pituitary axis response in the hippocampus. This is the part of the brain that releases hormones, and that contributes to the reproductive system.
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6. BLOOD SUGAR ISSUES
Blood sugar imbalances can contribute as one of the reasons for heavy painful periods. When you have unstable blood sugar with intense peaks and drops, you run the risk of insulin resistance. Insulin resistance occurs when the cells do not accept insulin when it tries to input glucose into the cell. This causes a hyperglycemic state as well as a high insulin state. Period pain can worsen with blood sugar imbalances because insulin will stimulate aromatase, an enzyme that converts testosterone into estrogen. The increase in estrogen is a factor for exacerbating the symptoms of period pain.
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7. CAFFEINE
Another one of the reasons for heavy painful periods is caffeine. Caffeine can increase the stress response in the body to promote inflammation and imbalanced hormone levels. Studies have found that caffeine consumption is linked with increased estrogen levels, leading to estrogen dominance, slower estrogen detoxification, and period pain. In addition, in a study of college students, they found a significant correlation of caffeine consumption with painful periods. A possible mechanism is that since caffeine can raise your blood pressure, this main induce an inflammatory response causes pelvic pain during menstruation.
8. NUTRIENT DEFICIENCIES
Many nutrients are used in the process of regulating, producing, and secreting sex hormones. Looking into nutrient deficiencies in yourself can give you a clue into one of the reasons for heavy painful periods. Here are some common nutrients that you may be deficient in that are causing you to have painful periods.
Magnesium is an important mineral in the diet and has many beneficial effects for reducing endometriosis period pain. A study found that magnesium has been shown to relax smooth muscle in the pelvic region to reduce painful contractions and cramps. They also found that magnesium supplementation was linked with an inverse relationship to endometriosis risk. Magnesium is also an anti-inflammatory mineral, which explains its effect on reducing period pain. This shows that low magnesium can make the endometriosis period pain worse because then contractions will be more intense due to the unregulated strain on smooth muscle.
Omega 3 deficiency can be another one of the reasons for heavy painful periods. Polyunsaturated fats are fatty acids that contain at least 2 double bonds in the structure. Two types of polyunsaturated fats are omega 3 and omega 6. Most western diets consume a ratio of 1:20 of omega 3 to omega 6 when it should be 1:3. This evidence is correlated with endometriosis period pain incidence, showing that omega 6’s are pro-inflammatory and promote the pain while omega 3’s have protective effects of decreasing the pain caused by inflammation. Omega 3s have been found to inhibit the implantation of the endometrial tissue in the first place and to discourage further growth.
Vitamin B6 is a water-soluble vitamin used in creating red blood cells and aids in macronutrient metabolism. Additionally, vitamin B6 has been broadly accepted over many studies to treat PMS symptoms including pelvic cramps. Estrogen metabolism is another one of the properties of Vitamin B6 which helps convert estrogen into its active form. This is why vitamin B6 deficiency can be one of the reasons for heavy painful periods.
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9. TOO MUCH ALCOHOL
Removing alcohol is an easy way to lower estrogen naturally. Alcohol can change the way our body eliminates estrogen, which can be what causes high estrogen when we over-consume alcohol. Studies have shown that this relationship is because alcohol can decrease or slow the oxidation process of estrogen, which inhibits the ability for it to turn into its preferred form to be eliminated. Additionally, estrogen and progesterone work on a balance system, when one is very elevated, the other one tends to drop low, so alcohol has been shown to decrease the levels of progesterone which causes high estrogen. By removing the alcohol, the progesterone levels can increase again, and which will lower estrogen naturally. This is why too much alcohol is one of the reasons for heavy painful periods.
Source: 11022013
10. INFLAMMATION
Inflammation is another one of the reasons for heavy painful periods. Inflammation occurs when your white blood cells sense an invader or an area of injury in the body, so they release chemicals to surge the area as well as increase blood flow there. Inflammation stimulates prostaglandins and hormone balances to induce period pain. In addition, when you have chronic inflammation the body needs to send you signals that something is wrong and needs to be fixed so increased contractions or cramps is a way to notify you that something is wrong.
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11. GENETICS
Genetics is another one of the reasons for heavy painful periods. Nerve growth factor has been identified to be a biomarker to tell a genetic role in pelvic pain. This is due to its connection to inflammation and how it can possibly predict reproductive diseases and conditions. This data suggests that period pain can be a genetic trait in families and can be passed down. It is important to note that just because period pain may be genetic in your family, does not mean you can’t treat it to ease symptoms.
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12. PRODUCTS WITH XENOESTROGENS
Toxic products contain xenoestrogens, which are chemicals that have a structure similar to estrogen. They are so similar that they can cause the same effects that our normal estrogen would in the body. These products can be one of the reasons for heavy painful periods. This is why non-toxic products can help to lower estrogen naturally. You may not know, but many of your daily household items contain these xenoestrogens. Here are some examples of some products and ingredients to stay away from.
Examples of xenoestrogens:
Sunscreens: 4-methylbenzylidene (4-MBC) and Benzophenone
Shampoos, face washes and lotions: If they contain parabens
Plastic packaging: BPA, phthalates, DEHP, PCBs
Food: Artificial dyes, and BHA a preservative
Cleaning supplies: ammonia, nitrobenzene, formaldehyde, phenol,
Building Supplies: PCBs in paints and electrical oils
Insecticides: Atrazine weed killer, dieldrin, endosulfan
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13. HYPOTHYROIDISM
Hypothyroidism is one of the reasons for heavy painful periods. This condition occurs when your thyroid is under-functioning, meaning that it is not producing enough thyroid hormones noted as T3 and T4. A study has found that women who have hypothyroidism also have more menstrual issues and irregularities, specifically heavy periods. Women experience a heavy period with hypothyroidism because both estrogen and the T3/T4 hormones can affect each other because they are both related to fat metabolism. When estrogen is out of balance in those with hypothyroidism, this can cause heavy bleeding during menstruation.
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14. ANOVULATION
Another one of the reasons for heavy painful periods is anovulation, which means you are not ovulating. It is still possible to not ovulate but still get your menstrual cycle, which usually occurs to women just before menopause. The anovulation occurs due to low hormone levels, specifically low progesterone which can lead to heavy periods. This period is still the shedding of the endometrium, but there is no egg passed.
Source: NIH
15. ENDOMETRIOSIS
Another one of the reasons for heavy painful periods is endometriosis. Endometriosis is a condition where there is a growth of endometrial tissue outside of the uterus, typically in the fallopian tube, vaginal canal, or ovaries. This tissue is estrogen-sensitive, and higher levels of estrogen cause increased menstrual flow and pelvic pain. Endometriosis occurs in women with increased estrogen levels, and therefore result in heavy periods.
Source: 26695831
16. FIBROIDS
As of a 2019 study, fibroids are the most common gynecological disorder in the US. Fibroids are noncancerous growths that can occur in the uterus. This condition can be one of the reasons for heavy painful periods because the mass can press against the uterine wall causing the endometrium to release more blood during menstruation.
Source: 30774352, Harvard Health
17. ADENOMYOSIS
Another condition that is one of the reasons for heavy painful periods is called adenomyosis. The condition occurs when there is an invasion of the endometrium into the myometrium, the muscular layer right next to it, causing the uterus to be enlarged. This condition is usually diagnosed in women in their 40s or 50s, and the cause is not entirely understood. The heavy periods and pelvic pain occur due to inflammation and swelling of the uterus.
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18. OVARIAN CYSTS
Ovarian cysts are one of the three diagnostic criteria for PCOS and they are one of the reasons for heavy painful periods. These cysts are sacs filled with fluid or with tissue that reside near the ovaries. 10 out of every 100 women have a cyst, and many are born with them, but in some cases, they are developed due to other causes. Additionally, some cysts are benign and cause no pain, but others cause pain and grow larger. Symptoms of an ovarian cyst are abdominal pain, irregular periods, heavy cramping, and pain while using the bathroom. Cysts can be one of the signs of low progesterone which is why they lead to heavy periods. In a study of dairy cows, they found that a single injection of progesterone in the early stages of cyst growth reduced its lifespan and resulted in the return of ovulation in some cases.
19. LUTEAL PHASE DEFECT
The luteal phase is the 12-16 day time frame that occurs after ovulation until the day before your next period. If the luteal phase does not occur at the right time this can disrupt the menstrual cycle and ovulation. Low progesterone levels from failed corpus luteum function result in disorders called luteal phase defects. In a normal menstrual cycle, the egg is released from a follicle in the ovaries and the resulting sac is called the corpus luteum which will produce progesterone to promote fertility. Examples of a luteal phase defect could be high prolactin as mentioned earlier, obesity, PCOS, and low thyroid hormone production. All of these factors can cause a luteal phase defect and will lead to low progesterone and heavy periods.
20. IRON DEFICIENCY
Now that we’ve listed all those reasons for heavy painful periods, let’s discuss one of the outcomes from heavy periods which is iron deficiency. This is because iron functions in the blood to help red blood cells carry oxygen around the body. All of our cells need oxygen for multiple chemical reactions that help us live. Because iron is highly concentrated in our blood if you have a heavy period, you lose substantially more iron than you would if you had a normal flow. Symptoms of iron deficiency include fatigue, shortness of breath, chest pain, coldness in hands and feet, and dizziness. Look into consuming more iron-rich foods like spinach, poultry, fish, and iron-enriched products like cereals, bread, and pasta.
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