heavy periods PCOS periods

Dealing With Heavy Periods and How to Know When They’re Too Heavy

Periods can be difficult to deal with especially on heavy days. Using the right protection to prevent leaks is vital.  Here are some tricks for handling flow on the heavy days and preventing nighttime leaks and surprise accidents when your period starts unexpectedly. Everyone has preferences when it comes to sanitary protection, and it may take some trial and error to find the product that works best for you.

Pads: Most people start out with sanitary pads. They come in a variety of sizes and shapes to fit your needs throughout your period. Some people like the pads with “wings” to prevent underwear stains, but others find them scratchy and irritating. The long pads work best for overnight use and heavy days. The most important thing about pads is to place them securely so they don’t shift front, back, or to the side allowing accidents. When using a pad, your underwear should fit snugly enough to hold the pad against your body. (A gap between your pad and your body is asking for leaks.) For comfort, the crotch of your underwear should be wide enough to accommodate the width of the pad. They make pads for thongs, but they’re not very comfortable. Consider using 2 pairs of underwear at night to hold the pad securely in place while you sleep. (Even better, see below about period panties.) Even during times of light flow, a pad should be changed every 4 hours during the day and after 8 hours at night to avoid bacterial build-up and possible odor. 

Period panties: This super-absorbent underwear comes in a multitude of styles (even thongs) and can be used alone on light days or with a pad, tampon, or menstrual cup on heavy days and nights to prevent accidents. (Many hold 2 tampons’ worth of flow.) Just throw them in the wash between wearings. They’re an eco-friendly way to deal with tampon overflow, light flow days, and when you’re waiting for your period to start. Many of them look like regular underwear and give you the confidence to wear white pants even if you have irregular periods.

Tampons: Tampons (and/or menstrual cups) are essential for dancers, swimmers, and other athletes who need to perform without risking a pad slipping out of place or showing. Yes, you are still a virgin if you use tampons–I get asked that a lot. It’s important to insert tampons correctly for them to be comfortable and effective. Many people don’t insert them far enough. If your tampon comes out when you go to the bathroom or if you feel the tampon the whole time it’s in, you probably didn’t insert it far enough and will get leaks, not to mention discomfort. You shouldn’t feel the tampon when it’s in correctly. You can’t insert it too far. If you can’t insert a tampon at all, talk to your doctor.

Even during light flow, it is important to change tampons at least every 4 hours to prevent serious (sometimes deadly) infections. Do not leave tampons in overnight. Always wash hands well with soap and water before and after using tampons.

Menstrual cups: Menstrual cups are eco-friendly reusable silicone cups that fit into the vagina just under the cervix to collect period flow. (Avoid the rubber ones since some people are allergic to them.) They are inserted like a tampon but need to be placed and rotated to form a seal between the cup and the vaginal wall to prevent leaks. When the cup is full, remove it and dump the blood in the toilet. The cup should be cleaned after each use. This can be awkward in a public bathroom. Be sure to follow the manufacturer’s instructions for cleaning, inserting, and removing the cup very closely. (Only water-based soaps and lubricants should be used.) Always wash your hands thoroughly with soap and water before and after inserting and removing your cup to prevent infection. When used properly a cup is less likely to cause a serious infection than a tampon, however, I recommend removing the cup every 8 hours. Unlike tampons, it is safe to use the cup overnight. Cups come in 2 sizes. Young women who have never given birth should use small cups. Sizing is based on the size of the vagina, not the menstrual flow.

Are your periods too heavy? It’s important to know what normal period flow is like:

Periods are usually 21-38 days apart (from the beginning of one period to the beginning of the next.) Flow usually lasts 2 to 7 days and is usually heavier at the beginning of your period and lighter toward the end. The average woman uses 20 pads or tampons per cycle

Your period is too heavy if:

  • Your flow is heavy enough to saturate a tampon or pad every hour for several hours
  • Your period comes more than once a month.
  • If your cycle lasts more than 7 days
  • You have to restrict your activities because of your flow
  • You have symptoms of anemia: easily fatigued, light-headed

If you have any of these symptoms, discuss your periods with your doctor.

There are many reasons you may have heavy periods.

Hormone Imbalance is fairly common: Polycystic Ovary Syndrome (PCOS), thyroid excess or insufficiency, obesity, and ovarian dysfunction (infrequent ovulation) can all cause heavy periods.

Bleeding disorders are less common: Von Willebrand disease, an inherited blood clotting disorder, or platelet dysfunction can cause heavy periods.

Infection: Infections of the reproductive organs and sexually transmitted diseases can cause heavy bleeding. These infections are sometimes accompanied by fever, pain, or discharge, but sometimes there are no other obvious symptoms.

Structural problems of the reproductive system are less common causes in teens and young women.

There are a few medications that can cause heavy bleeding. Let your doctor know if you are taking any anti-inflammatory, anticoagulant, hormone medications.

Your doctor will ask specific questions about your periods and family history, do an exam, and possibly order some bloodwork or ultrasound to find out why your bleeding is heavy. 

Sometimes hormone therapy like oral contraceptive pills or progesterone is needed. A hormonal Intrauterine device (IUD) can be very helpful for both heavy bleeding and cramping. Taking ibuprofen the day before your period and through the first 2 days of the period can decrease flow. Ask your doctor if this will work for you.

Heavy periods are often a result of estrogen excess. There are some natural things you can do to help:

Avoid using products with lavender or tea tree essential oils because they can have estrogen-like effects on the body.

Try adding red grapes, pomegranates, mushrooms, flaxseed, whole grains,  green tea, cruciferous vegetables (broccoli, kale, cabbage, cauliflower), soy, and legumes (beans, lentils) to your diet. These foods help the probiotics (friendly bacteria) in your gut regulate estrogen.

Daily exercise also helps regulate hormones.

Decreasing dairy foods can help some women. (try substituting a glass of organic soy milk for one  or more of your milk servings a day)

Avoid alcohol which can dysregulate hormones and make periods worse.

Take a probiotic supplement containing L. gasseri (like Phillips Colon Health)for a few weeks.

(These dietary measures are safe regardless of your estrogen levels.)

If your periods are heavy, it’s important to eat iron-containing foods like meat, fish, tofu, nuts, seeds, or fortified whole grains daily. Vegetarians sometimes have trouble eating enough iron-containing foods. Ask your doctor if you need an iron supplement.

Here are some recipes for foods that support period health

Magic Matcha Grape Smoothie

½ cup red grapes, fresh or frozen, cut in half

½ cup frozen blueberries

1 cup organic soy milk or vanilla soy milk, or almond milk

1 single-serving packet of matcha green tea powder like (Pure Leaf)

½ cup fresh kale (Optional)

1 Tablespoon ground flax seeds (Optional)

Blend very well and enjoy.  Keep in mind that this smoothie contains caffeine. Enjoy it before 2 pm.

Tip: buy fresh local red grapes in season (late summer to fall) when they’re cheapest. Slice in half and freeze in single layers in heavy-duty freezer bags for use in seasons when grapes are imported.

Girl Power Salad

½ cup cooked organic edamame, cooled

2 Tablespoons sunflower or pumpkin seeds

1 cup seedless red grapes, sliced in half

½ cup pomegranate arils

½ cup grass-fed feta cheese, crumbled (Optional)

4 cups kale or baby kale-green mix


2 Tablespoons apple cider vinegar

1 teaspoon dijon mustard

¼ teaspoon onion powder

¼ teaspoon garlic powder

⅛ teaspoon salt (omit salt if you are using garlic salt rather than garlic powder)

¼ teaspoon black pepper

1 teaspoon honey (optional)

Combine dressing ingredients in a small jar with a tight-fitting lid and shake well.

If using regular kale, wash well, pull the tender leaves off of the fibrous stems and tear them into bite-sized pieces. Crush kale leaves in your hands to tenderize.

If using baby greens, skip the previous step.

Toss cooled edamame, grapes, pomegranate, salad greens, and cheese with as much dressing as you like. Enjoy!

Quinoa Mushroom Bowl

1-pint button mushrooms, sliced

2 cloves garlic peeled and crushed

2 tablespoons extra virgin olive oil

1 cup quinoa cooked according to package directions

Salt and pepper to taste

Heat olive oil in a large skillet over medium-high heat. Add garlic and mushrooms, salt, and pepper. Toss to coat then spread the mushrooms out in a single layer. Cook 3 minutes undisturbed, then flip the mushrooms and cook for an additional 2 minutes. Stir mushrooms and reduce heat to medium-low. Stir occasionally for another 5 minutes. Toss with warm quinoa.

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