Heavy periods affect around one in five women of reproductive age in the UK.
Combined with the stigma that already surrounds menstruation, the pain and fear of leaks or clots can have a debilitating effect on people’s lives – not to mention leading to some uncomfortable moments in the bedroom (as Michaela Cole captures in a recent episode of her BBC3 show I May Destroy You).
In Am I Making You Uncomfortable? this week, we hear from our listeners about the realities of heavy periods – and learn more about what’s going on with our bodies.
We’re joined by HuffPost UK reporter Tasha Hinde, who shares her experience of menorrhagia – the medical term for abnormally heavy bleeding.
In her words, Tasha’s periods resemble “the elevator scene in The Shining”. She talks about filling “a tampon and a maxi pad in the space of 15 minutes” and the physical and emotional impacts of the condition.
We also speak to gynaecologist Dr Brooke Vandermolen, who runs The OBGYN Mum blog, about what counts as a “heavy” period, plus what we can do to manage heavy bleeding.
You can subscribe, download and listen to Am I Making You Uncomfortable? on Spotify, Apple Podcasts and all major podcasting platforms and you’ll find a transcript of our chat below, to make the podcast accessible for all of HuffPost’s wonderful readers and listeners.
Join in the conversation on social media by using the hashtag #AIMYU – and go behind the scenes by subscribing to our podcast newsletter to hear what inspired us to tackle the topics you’re probably too squeamish to talk about.
Episode 9 Transcript:
Brogan:
Hello, and welcome to HuffPost’s brand new weekly podcast Am I Making You Uncomfortable presented by me, Brogan Driscoll.
Rachel:
And me, Rachel Moss. This podcast is a frank, honest conversation about women’s bodies, health, and private lives. This week we’re discussing heavy periods.
Testimonial 1:
So I used to have manageable periods until I got my copper coil fitted a few years ago, which I would really recommend. I think they’re amazing. But for me, personally, it’s meant that one day of my period is really heavy. So there have been a few awkward situations. For example, last year I went for dinner in a nice hotel and we were sat speaking with the owners and I got up to go to the loo and realised I’d leaked through my dress and onto their very nice chair. Yeah, that was quite embarrassing.
Testimonial 2:
I’ve experienced heavy bleeding throughout my period since my teens, especially the clotting is what I’ve found most difficult to manage and deal with. I was eventually diagnosed with endometriosis about seven, eight years after really making up a fuss about it. And I’m on tranexamic acid, which helps lighten the flow slightly.
Testimonial 3:
My period feels often like an uphill battle, if I can be honest. Not only do they tend to be heavy and uncomfortable, but they can be rather painful. And I also have clots in my periods, so it’s not very comfortable. And I’ve been in situations where if I’ve had staining come through my trousers, which has happened a few times, it’s been really embarrassing, and I’ve needed to come home and get changed.
Rachel:
Heavy periods or menorrhagia affects around one in five women of reproductive age in the UK. It’s defined as abnormally heavy or prolonged bleeding and is one of the most common gynecological complaints. It might not be life-threatening, but combined with a stigma that already comes with periods, it can have a really debilitating effect on women’s lives.
Brogan:
You can take part in the conversation using the hashtag AIMYU. Now we’re going to talk about periods, which feels quite apt because I am on my period today.
Rachel:
Oh. Well, thanks for sharing. I was also going to start things with a TMI and tell you a couple of weeks ago, I said to my boyfriend, “God, I don’t know whether I’m going to get through the podcast recording because I’ve got a really heavy period.” And he said, “Why don’t you just sit on a towel?” And I said, “That should be the title of our next podcast, Why Don’t You Just Sit On A Towel?” So, there we are.
Tasha Hinde:
It’s basically my life.
Rachel:
Yeah. And that brings us nicely to introduce Tash actually, who you can hear already because she’s great. For this week, we’re joined by our colleague Natasha Hinde, who is a reporter at HuffPost, and Tasha’s very kindly agreed to join the Am I Making You Uncomfortable? party because she has heavy periods or menorrhagia. Thanks for joining us.
Tasha:
Thank you for having me. What a treat to talk about my periods.
Brogan:
Are you sat on a towel right now, Tasha?
Tasha:
I’m actually not. I’m not on my period thankfully, otherwise it’d be like the ‘elevator scene’ from The Shining.
Rachel:
Yeah, it’s a glorious image. That’s glorious.
Tasha:
Yeah.
Rachel:
So we are talking about the heavier side of periods today. Obviously it comes on a huge spectrum and because we don’t really see anyone else’s periods, it’s really hard to know what counts as a heavy period and what is normal and what is not. Can we kick things off by you talking about your experience? So when did you realise that your periods might not be normal or the norm?
Tasha:
There wasn’t a light bulb moment, but it was more of a sort of gradual realization that I was just really struggling with them. So I didn’t really have particularly in-depth conversations with friends at school. We’d just say, “Oh, I’m on,” or, “Oh, I’ve got bad cramps this week,” but that was about the long and short of it. I did have quite in-depth conversations with my mum about it, mainly because she could see how much pain I was in. She could also see the state of the laundry, because my bedsheets would be constantly just covered in blood, my clothes would be covered in blood. I was wearing maxi pads to school, which we all know maxi pads. They have that distinctive rustling sound which is delightful at school.
Rachel:
Yeah.
Tasha:
Yeah, really, really fun when you’re already a mortified teenager to be rustling around the classroom. I would just constantly be leaking, and I think it got worse as I entered my late teens. And I remember being at uni once and going to this seminar, and all of a sudden I could just feel like damp, sitting in damp. At this point I was wearing sanitary towels and tampons together to try and keep it all in. But I just remember thinking, “Oh God, I’ve leaked.” And rushing to the toilet midway through the seminar, seeing all this blood all over my trousers, and I didn’t have like a jacket. Thankfully I’d driven to uni that day. So I just rushed to my car and went home and missed the rest of the day. And that is sort of like how it has been throughout, just the embarrassment of leaks and the pain. It’s just quite a lot to deal with when you’re young, and you just feel quite on your own, like lonely.
Brogan:
We talked about when you realised that they were heavier than other peoples, was that something that you were aware of because of the conversations you had with your mum? Or was it kind of through later scenarios?
Tasha:
I think it was through the conversations with my mum, but also, to be fair, I think that my mum had heavy periods so in our family it was just normal. I was diagnosed with menorrhagia or heavy periods when I was in my late teens, and that was because I went to the doctor’s and I was just really struggling with the pain and the fatigue and weakness that you get probably because you’re losing so much blood. And I’m only five foot, so to me it felt like I was literally losing my body weight in blood. But I went to the doctor’s then because I was just struggling. And my mum had been like, “You know what, why don’t you go see a GP about it if you’re worried.” And that was when they diagnosed me with it, but I still didn’t know how other periods were at that point. It was only really when I started working at HuffPost and we all had quite casual chats about our periods in our morning meetings and at lunch breaks that I was like, “Oh God.”
Brogan:
Rachel and I were talking about this because I’ve worked with you for what, like, five years and for such a long time had no idea that this was something that you were dealing with. And a couple of years ago, HuffPost did a week-long kind of series about periods and Tasha and I were little guinea pigs and tried those absorbent period pants and wrote at length about our experiences and our concerns about them.
Rachel:
What was that like for you, Tash, taking part in that experiment? Do we call it an experiment? Considering that you have such heavy periods.
Tasha:
I was quite apprehensive about it, to be honest, because I’m used to sort of having double protection, but even that doesn’t quite work. So I was thinking, “Oh God, are these pants going to keep everything in?” But actually, it was a bit of a game changer for me having heavy periods, and I wished that I’d have known about these pants when I was at school because it would have made my life so much easier and would have saved, probably, a lot of bedding. But I guess it was quite scary writing about it. I mean, you had to be graphic about it because that’s the whole point of the review. People want to know, are you going to leak everywhere? Is it all damp and wet when you’re just sitting in these pants? So I was quite apprehensive, but it felt like quite a relief to write it and just sort of get it out there. And a lot of people read that article as well, which was… It just shows you how people are desperate for this information, but we just do not talk about it and we need to.
Rachel:
Yeah, yeah. Definitely. You mentioned that you first went to the doctor’s in your late teens, so I wanted to go back to that, because I know when we’ve spoken about these kinds of women’s health problems in the past, sometimes it takes people quite a long time to go. Sometimes when people do go, they feel like they’re not taken seriously or they’re a little bit fobbed off. So what was your experience like? Did your doctor get it when you first went?
Tasha:
To be fair, my doctor did get it pretty much straight away and was like, “It sounds like you’ve got this menorrhagia, which are heavy periods.” He was like, “We can try you on these pills, and we’ll sort of go from there and see how it goes.” The pills were called mefenamic acid and you could take a few a day and it basically lightened your period and ease the pain. But I was quite aware from poring over the leaflet that came with it that it wasn’t something that you should take for prolonged periods of time. And when you think about that the average woman is on her period for what, 40 odd years, it just seemed a bit like, okay, so this is a useful solution, but I was quite aware that I only wanted to use them as and when I really, really needed to rather than sort of become reliant on them.
I did, in my early twenties, go back to the doctor and tried a few different types of contraceptive pill, but I was then getting other issues from just taking the pill. And then in the end I was just like, “Oh, is it worth it? I should probably just shut up and put up.”
Rachel:
I hate that phrase, shut up and put up, because I feel like if women’s health stuff was researched more, we wouldn’t be shutting up and putting up. I’ve heard from so many women writing about women’s health, and particularly the pill that you just mentioned, that there’s so many varieties out there and you’re just told to go from one to the other to the other and have none of them worked for you then there’s nothing, no solution.
Tasha:
Last year actually I did go back to the doctor’s about the issue because… I don’t know what was going on with my body last year, but it just seemed to really kick off. And I remember I filled a tampon and a maxi pad in the space of 15 minutes. I was getting blood clots the size of 50p coins. Honestly, it was extreme. And I went back to the doctor’s because it started feeling like someone was taking a sledgehammer to my womb. I remember just sitting on the edge of the bed on multiple occasions being like, “Should I just get my womb removed?” Would it genuinely be easier if I just had it removed? Because it feels like I’m on a period for half of the month because I get the pain a week before, I get PMS, then the period hits, it lasts for like eight days. It’s three days of heavy, heavy flow, and then it gradually sort of siphons off. You’re getting blood clots, you’re leaking, you’re embarrassed, you feel tired, fatigued.
Tasha:
I remember getting on a tube, multiple occasions, to come home from work and just feeling like I was going to pass out because I just felt so weak, and it was always on day one, day two of my period. And one time I had to get my boyfriend to basically just come and pick me up in a taxi because I just thought I was going to pass out, and I couldn’t walk. You also worry about being seen as a drama queen.
Brogan:
There’s such a kind of negativity around the way that we talk about periods. I don’t know if you remember growing up, people would be like, “Oh, are you on your period?” There’s just so many negative assumptions made, I guess, around women that you’re exaggerating or you’re in a bad mood because of your period and all of these things. And it’s so unfair when for some people having periods for two weeks of the month is really debilitating. There has been so much discussion in the past about the idea of period leave and people taking time off from work or school because of period pains. You have a really hard time with it. Is it something that you think you would take if it was an option?
Tasha:
Yeah, I definitely would take it. I think we try and sort of work through our periods because it’s not seen as an ailment or an illness and you’re just sort of like, well, this is what happens to my body every month. It’s like, just got to grin and bear it sort of thing. But, to be honest, there have been days where I’ve been at work and… What is the point in being at work and then being hit with all of this pain and also worry that you’re going to leak all over your office chair in front of all your colleagues, which is not a fun worry to have. But you can’t concentrate.
There’ve been occasions where I’ve gone to the toilets because I’ve been in so much pain and I’ve had a cry and it’s just like: if it was any other sort of issue you would just take a day off. And I have. To be fair, I have taken days off because of my periods before, school, uni, work, because it’s just been too much and I’ve just been like, “I can’t. I can’t actually work so there is literally no point.” And you just make up for it elsewhere. It doesn’t mean that you’re not working hard. You just work hard the next day when you can actually manage it. So I think period leave would be really helpful, especially… a lot of women do have really bad periods. We just don’t talk about it, I guess, and we need to start talking about it.
One of the things that’s been quite a game changer actually is being able to speak to colleagues and your boss about it. Obviously not everyone is in a position to speak to their boss about how they’re feeling and their periods, but I do think that is a game changer and if we can make sure that workplaces are more period friendly. Oh my God, what a slogan, period friendly workplace. But I think it would make a huge difference to a lot of people’s lives.
Rachel:
Yeah, I totally agree. I love what you just said about “you do make up the work, you just do it the next day” or whenever. Because, I think for me, I love the idea of period leave and I a hundred percent support it and I definitely think it should be a thing, but for me personally, would I ever have the guts to say, I need to take off a day off my period? I genuinely think I would worry about the judgment because, as Brogan was saying, there’s stigma, as a woman in the workplace, especially if you’re in a male dominated industry, you’re already thinking you’ve got to work twice as hard for whatever recognition.
Brogan:
And I think also, if you’re thinking about the happiness of your workforce and productivity and all of that, if someone’s really unwell with period pain and they can’t concentrate and they’re totally distracted, it’d be better for them to take the day off and then come back when they feel better, then they’ll kind of feel more positive about their workplace and care about them and they’ll work really hard.
Tasha:
I think it comes down to sort of compassion and trust, compassion for the people that work for you. And I think this pandemic has made us all realize that we’re all human beings, we’ve all got stuff going on, and we’ve been checking in with one another more. It is so important that we all talk about periods because otherwise, how do you know if anything is wrong? Last year, I actually went to the doctor’s again and was like, “I need to have some form of investigation. I want to make sure that it’s all okay down there.” I had an ultrasound. They did find that it was okay, but I think it’s so important that women really do push for these investigations if they don’t feel something is right, because there could be issues going on underneath. And I think I read somewhere that it takes the average woman 11 years to be diagnosed with endometriosis, and it’s just such a long time to be struggling. And by that point, 11 years down the line, you could have had some form of preventative treatment to stop it progressing. So I just think it’s really important that A) we talk about periods; and B) that don’t just be sort of fobbed off with pills sometimes. Do have the confidence to push for more because you deserve it.
Rachel:
Yeah, definitely. And these conditions are all so similar, but they are different so that’s obviously why it’s so important to speak to a doctor and find out which one you do have, so you can get the right treatment. You make such a great point on that. We also wanted to ask you about what’s worked for you? So you mentioned the period pants earlier. Can you tell us anything about the products that you tend to use and what’s been good and what’s been not so good.
Tasha:
Yeah. I used to use a combination of tampons and sanitary pads. To be honest, it was just quite uncomfortable wearing the sanitary pads. Don’t know. Just like chafey. Not a fan.
Rachel:
Yeah.
Brogan:
Rustley.
Tasha:
Rustley, chafey, not particularly breathable. When we did the period project at HuffPost, the pants that I tried were from Modibodi, and they were, I think, the heaviest flow… Because they have different pants for different flows. Mine were the heavy, heavy flow pants, and actually I’ve kept using them every month since. I’m planning on putting a bulk order in, because I’ve only got two pairs and I could do with a few more. So now I tend to wear those, but I have been using them with tampons as well, because just for that extra protection. I think there’s always a worry in your mind that you’re just used to the leaks, so you want to make sure that that does not happen. But period pants are definitely a game changer. I would recommend those for people with heavy periods.
Brogan:
So we ask all of our podcast guests the same question and that is, what makes you uncomfortable?
Tasha:
Awkward silences. They are the worst. And I have noticed a lot of them during this pandemic because obviously you’re having lots more video conferencing and meetings. I just cannot deal with the awkward silence, so I tend to fill it with oversharing. Oh, God. There’s going to be an awkward silence now.
Rachel:
I feel like we should just be silent just to test that, but it’s probably not great for any listeners.
Tasha:
Yeah. I’d much rather talk about periods and blood clots than have to face awkward silences, so there you go.
Brogan:
Thanks so much, Tash, it’s been great having you on.
Rachel:
Yeah, thanks, Tash.
Brogan:
Thanks for sharing your story with us.
Natasha:
Thanks for having me.
Testimonial 4:
So I went on the pill at the age of 30, just because I had heavy periods since I was a teenager. I mean, my nighttime routine was basically two giant pads, overlapping two pairs of pants and sometimes even a towel on the bed. That’s how scared I was of just bleeding everywhere. And the pill changed all of that, but 10 years later now I want to come off it. I have come off it, and I’m petrified that they’re going to come back in that way, so I’ve started working with a nutritionist to see if we can somehow balance out my hormones. But, yeah, it’s a real fear because I really don’t want to get back to that.
Testimonial 5:
My periods have taken over my life for nearly eight years now. Back in the day I had regular three-day periods, four weeks apart. Now it’s at least five days every three weeks. I have to wear night pads all the time, which I have to change every couple of hours, otherwise I’ll bleed everywhere, which has happened many times. I breakthrough bleed when I exercise, if I have sex and sometimes for no apparent reason at all. I am at times physically sick from the pain. I am severely anaemic and I don’t feel sexy at all ever with what’s going on down there.
When I saw my GP in my late thirties, she told me it was because I was getting old and prescribed the pill, which made it worse, until finally, an ultrasound showed multiple fibroids, including one 10cm in diameter. I had uterine artery embolisation, where they shoot glue into the arteries feeding the fibroids, and it worked a bit short-term, but because of where the fibroids are, the only option I have left is hysterectomy, which I don’t want because it’s such major surgery. So right now, I’m just waiting for the menopause, when hopefully my life can start again.
Brogan:
Next up we’re joined by Dr Brooke Vandermolen, registrar doctor in obstetrics and gynaecology, the founder of The OBGYN Mum blog about women’s health issues, and she’s also the co-founder of The Birth Collective, which provides online antenatal classes. Thank you so much for joining us.
Brooke:
Thank you so much for having me. It’s great to be here.
Rachel:
We are very excited to absorb all of your knowledge. We’ve just been talking about period pants actually so that feels very fitting. We were joined by our colleague Natasha in the first part of the podcast because she has been diagnosed with menorrhagia, so we wanted to learn more about that. Can you tell us what some of the causes are?
Brooke:
Yeah. So I guess first of all, for anyone that doesn’t know, menorrhagia is another term, the more medical term, for heavy menstrual bleeding. That is really, really common, probably far more common than we realize. It affects around 14 to 25% of women of reproductive age. So basically a quarter of us, and one in 20 women see their GP about this issue each year, so it’s really, really common. And what it is is when you are bleeding heavily for your periods, and I think that’s quite subjective. So the first thing to say is like, if you think you’ve got heavy periods, you have heavy periods, and telling somebody, you don’t have heavy periods because you don’t bleed enough, that’s not that helpful. I think if you find the bleeding is too much for you, it affects your everyday life, then you can seek help for that.
But kind of medically speaking, we have got a definition for it and that’s if you bleed more than 80 mls or more in the course of your periods. Actually it’s a very small amount, if you were to measure it. It’s about six to eight teaspoons of blood. Anything more than that is heavy bleeding, because although it looks like a lot, the blood we lose during our period, it’s actually not that much. Or if you bleed for longer than seven days, that’s also classed as heavy menstrual bleeding.
There’s a number of different causes. The commonest cause is just because. Just because some women bleed more than others and it doesn’t have a pathology associated with it, it doesn’t have something underlying it as a cause. But that is a common reason, but there are underlying reasons that you can have heavy bleeding. So I would divide them into two categories, structural and non-structural. Structural things that can give you heavy bleeding are fibroids, which many women might have heard of. Really, really common. Polyps, which are kind of little growths on the lining of the womb. Or more rare things where the lining of the womb grows too thick, so that’s called hyperplasia and can become endometrial cancer, but that’s much, much rarer cause of very heavy bleeding. The most important thing is if you think something’s wrong, then to seek help and we can try and help you to work out why.
Rachel:
Yeah, absolutely. I noticed you said menorrhagia and I’ve been saying menorrhagia, which makes me sound, I don’t know, like I should be wearing a top hat and riding a horse and playing polo. Have I just been getting that wrong? How are you meant to say it?
Brooke:
Yeah. I think we would say menorrhagia, but I understood perfectly what you were saying, so whatever feels comfortable for you.
Brogan:
Okay. I’m going to have to remember that, menorrhagia. Menorrhagia. We had Tasha on earlier on the podcast who spoke about her own experience of heavy periods and specifically blood clotting. She mentioned that sometimes she has blood clots the size of a 50p, which for me, I have always had quite light periods, that was quite surprising. Is that common? When should there be concern? We’ve heard that some women sometimes mistake blood clots for miscarriages as well. Could you talk a bit about that for us?
Brooke:
Yeah, absolutely. So it’s a really good property of our blood that it kind of forms clumps and clots, and that’s what helps us. For example, if you cut yourself, your blood clots in order to form a scab to stop you from bleeding out. So it’s a normal property of our blood, and our period blood, if there’s kind of quite a lot of it, it can do the same thing. It can start to stick together in clumps. And it’s very common to pass clots in maybe the first day or two of your periods, which tend to be the heaviest days.
In terms of whether or not it’s abnormal, as part of “Should I see a doctor? Are my periods too heavy?” As well as the things I mentioned earlier, so the blood loss being more than 80 mls total or lasting seven days or longer, there’s a couple of other things that we would include in that. So if you are passing blood clots bigger than a 10p piece that would suggest the bleeding is a bit heavier than normal. So one of the properties of our blood, which is really useful, is the fact that our blood can clot so that clumps of it form and stick together. So if you were to cut yourself, for example, that’s the property of blood that stops you from bleeding out. It’s a good thing, but the same way that the blood kind of going around our body can clot, when we’re losing blood in our period, that can, if there’s quite a lot of it, clump together and form these clots that we can see.
And it’s pretty common to pass some blood clots, especially in the first day or two of your period when the bleeding is heaviest, there’s more blood around and it might stick together. But there’s a couple of extra things that I would add as well. So passing blood clots bigger than a 10p piece would be a suggestion that you’re probably losing more blood than average. Also other things include: flooding through your clothes, if you’re kind of finding that you’re wearing maybe protection and you’re still bleeding through; if you have to double up pads and tampons; if you’re needing to change your sanitary protection every one to two hours – those are all suggestions that probably this is excessive uterine bleeding and we’d advise you to see somebody and see if we could do something to help.
Rachel:
All the stuff on blood clots there reminded me. I actually had this last year for the first time and it was really horrible. I had a really big blood clot, and I’d never really had them before. And I did that thing where I panicked and said, “Is this a miscarriage or is this part of my period?” And I wasn’t sure and I spoke to my doctor. And one of the things that she spoke about was in terms of the cramping that she was asking me about the cramping that I felt before I’d passed this large clot to try and discern what had actually happened. Can you tell us anything about that? How would a woman maybe know, “okay, this is period” or this is a miscarriage?
Brooke:
So, I mean, the first thing would be to say, have you had a positive pregnancy test? Because it is hard to know if it’s been a miscarriage where that’s happened so quickly after say your period was due, you didn’t see your period when it should, but a couple of days later you start bleeding heavily than normal. So yes, that would be considered a miscarriage or a very, very early pregnancy loss. And the best way to know it would be to have a positive pregnancy test before that. So I wouldn’t advise people who were trying to conceive to take pregnancy tests too early in their cycle. Normally if you can wait until the day that your period is due, it’s more likely to give you an accurate result. Having a positive pregnancy test would be the best way of knowing was I pregnant this month and then I just happened… the pregnancy passed a day or two later.
Rachel:
That’s really helpful to know. You mentioned fibroids being one of the major causes of heavy periods. Do heavy periods affect some communities of women more than others?
Brooke:
Black women are definitely much more likely to experience heavy periods and also kind of have higher rates of needing to go to hospital and having kind of surgeries and things like that. So it’s something we have not been speaking about enough and I think, thankfully, everything that’s been going on over the last few weeks is encouraging everybody to raise the voices of black women and talk about these issues because there is a lot that needs to be improved in this area. So absolutely, first of all, recognising that black women do experience this problem more and they need closer attention. So black women are two to three times more likely to have fibroids.
Fibroids are incredibly common in white women as well. They would be present in around 70% of white women, but it even higher in the black population. Fibroids are benign growths in the womb that kind of form up to the size of kind a tennis ball. So they’re little balls that grow, and they don’t tend to become cancerous, they just grow in the lining of the womb and they can cause much heavier bleeding during periods.
They don’t tend to cause pain unless they grow so large that they’re taking up a big amount of space in your tummy, and they can kind of distort almost the size and shape of somebody’s abdomen because of the fibroids that enlarge their uterus. And it makes them much more likely to have heavy bleeding during their period. And again, if we’re just talking about the black community, they would have a three times higher risk of needing to be hospitalised because their periods are so heavy that they become anaemic and need to go to hospital, for example, to get a blood transfusion.
So those things are all more common in this group of women, as well as just generally pelvic pain, being anaemic, having heavy periods that are affecting their lives, needing to take time off work, needing to miss out on days at school, things like that. So, yeah, absolutely this is a really important issue to talk about. And as I said earlier, they’ve got two to three times higher likelihood of having a hysterectomy in their lifetime because of fibroids or heavy bleeding.
We have a lot of other treatments these days, some that just medications or laparoscopic operations, which are less invasive. And I think we need to make sure that this community gets the right treatment, that we maybe hopefully overall reduce the number of hysterectomies that need to be done, but providing the right treatment and just increasing the awareness of everybody to take this seriously, make sure that pain is recognized and treated adequately.
Brogan:
So we know that it can take women a long time, sometimes years, to seek help and indeed get help. Why do you think that so many women suffer in silence for so long?
Brooke:
Yeah, absolutely. The highest rate of presentation, the age at which people present is between the ages of 40 to 51 seeking advice about heavy periods, and I think there’s a number of different reasons why this happens. The first thing is everyone just assumes, this is normal. You might even speak to your mom or your grandma, and they say, “Yeah, yeah. I had really, really heavy periods. Oh yeah, well, I had my menopause, then it all stopped so just kind of wait.” Or people think, “Oh yeah, well, I’ve got heavy periods now, but I’m planning to get pregnant then I won’t have periods for a while.” So they kind of delay needing to seek treatment for those reasons.
I think people are also aware that a number of the treatments for heavy periods might involve hormones, worried about taking hormones or maybe they want to get pregnant so they don’t want to affect their chances, that sort of thing.
I think there’s a lot of different reasons that play into delaying this. And the thing that I would say is those aren’t our only options. And also the other thing is people think we’re going to jump into surgery and maybe they’re worried because someone in their family has fibroids. They think, “Oh, that’s it. As soon as I go there, they’re going to tell me I’m going to need to have a hysterectomy.” So I would obviously encourage people to say there are a number of treatments. There’s treatments that don’t involve hormones, there’s treatments that do involve hormones, but no surgery. There are things that we can do to help you without affecting your fertility. So don’t wait if you think you fit into any of those categories we spoke about before.
But I think the other reason why people also tend to seek help maybe a bit later on in life is it can get worse, especially around that perimenopausal time. Women often experience much heavier periods in the run-up to their periods stopping completely. And it’s as the hormone levels fluctuate, as we’re running out of eggs approaching the menopause, that can result in heavy menstrual bleeding. So everyone kind of thinks, “Oh, probably I’m getting close to the menopause, they’ll become really light and maybe less periods,” but actually it can often be much heavier in that kind of year or so before the menopause.
Brogan:
And that’s what you mean by perimenopausal or kind of like just before was it?
Brooke:
Yes. The perimenopause is the time when you’re experiencing menopausal symptoms, but your periods haven’t yet stopped. So that can go on for a year, two years, even longer for some women. But they might start experiencing heavy periods, hot flushes, mood swings, that sort of thing. Even though they’re still getting some periods, that’s the perimenopause, and menopause is when the periods have stopped completely.
Rachel:
So I personally feel like my periods are getting heavier by the year. It is a fricking nightmare. Do your periods in general change throughout your life or do they have their own personality? Are they a light or heavy period for the whole of your life? How does it work?
Brooke:
No, absolutely they do change through your life, and I think that’s definitely a misconception that I am this type of person, therefore I shouldn’t have another problem. When we start having our periods, they will often be all over the place. We probably could all remember when you were in your early teens and they’re completely irregular, or they might be so heavy and you miss loads of days off school or so painful, but that changes when you kind of come into adult life. You might start things like the contraceptive pill, or you might start taking other things during your life as well that will affect your periods.
But even if you weren’t to take anything, yes, they will be kind of all over the place at what we call menarche, which is when we start our periods for those first few years. They settle down maybe into a pattern. But a lot of women do notice that after they’ve had a pregnancy, so after they’ve had a baby, their periods may become much more irregular in the few months afterwards. It could be affected also by breastfeeding, but they can become irregular. They can, once they do restart and fall into a regular pattern, many women notice they are much heavier for the several cycles after having a baby. And that can even take quite a bit of time to settle down.
And then again, as I mentioned before, coming up to the menopause, again they can change. And some women, they get much heavier. For other women, they might get much lighter. So, yeah, they aren’t static through your lifetime. And again, if you have any of those problems we were discussing before as well, that will affect it. So fibroids grow over time, they also regress over time. You might have bleeding conditions, things like that. So there’s so many reasons why your periods may change through your lifetime. So don’t just think, “This is me. I’ve got to put up with it.”
Brogan:
Thanks so much. That was really so interesting. I’m full of loads of information that’ll be really useful for listeners, and I like how Rachel and I both snuck in little sneaky questions about our own periods.
Rachel:
Oh, yeah. Absolutely. I’ve treated this like a GP appointment, sorry.
Brooke:
My pleasure.
Brogan:
We have one question that we put to all of our guests on the podcast, which is what makes you uncomfortable?
Brooke:
The thing that makes me uncomfortable is taboos. And I think that makes everybody uncomfortable, but that’s also why I started my page. We all feel uncomfortable talking about things like periods or sex or incontinence. What I want to do is to make us all feel more comfortable. And like you guys are doing with this podcast, let’s get talking about the things that make us feel uncomfortable so we can kind of get rid of them and make sure people seek treatment, help at the right time, earlier than leaving things too long.
Rachel:
Love that. Thank you so much for joining us.
Brooke:
Thank you.
Brogan:
Thank you so much. It’s been great having you on.
Brooke:
Yeah, thank you so much for having me. Bye.
Rachel:
Bye.
Brogan:
That was Dr. Brooke Vandermolen, and earlier we heard from our teammate Tasha Hinde who is a reporter at HuffPost.
Rachel:
That’s it this week from Am I Making You Uncomfortable. Please subscribe to our podcast and give us a nice review. I’m Rachel Moss and you can find me @rachelmoss_.
Brogan:
And I’m Brogan Driscoll, and you can find me @Brogan_Driscoll. Thank you to our producer, Chrystal Genesis, our assistant producer, Rachel Porter, and our sound engineer, Nag Kirinde.
Rachel:
And if you want to get in touch to tell us what makes you uncomfortable, we’d love to hear your ideas on future podcast topics. You can reach us by emailing AIMYU@huffpost.com. You’ve just listened to Am I Making You Uncomfortable. #AIMYU.
