What is “Not At Risk”?
Your score indicates that the symptoms you described show that you likely do not have a bleeding disorder. An online tool can never diagnose someone though and we understand that you may still have a lot of questions about what may be causing your symptoms. To learn more about other potential causes for your symptoms it is important to talk to a doctor.
In the meantime, here are some additional questions and answers that can hopefully help you in your journey to feeling better.
Who Should I Make An Appointment With?
Many women start by seeing one of the providers listed below. Depending on your health insurance coverage, you may need a referral to see certain providers. Contact your insurance plan for specifics.
OB/GYNs (obstetrician/gynecologist) focus on women’s reproductive and sexual health and are a good source of information around symptoms such as heavy periods. This may be a good provider to make an appointment with, if heavy periods or excessive bleeding following labor and delivery or after a miscarriage were some of the symptoms you identified.
Primary Care Physician/Pediatrician
A PCP (primary care physician) provides preventive care and basic diagnoses of common illnesses and medical conditions. PCPs are also referred to as internists and sometimes even family practitioners. For children and teen girls, the equivalent would be a pediatrician. Learn more about these different types providers.
Healthcare providers on campus
If you are currently enrolled in college, many college and university campuses have a campus health center, with a variety of health care providers (such as internists and OB/GYNs) for students to see. Other campuses, who don’t offer their own clinics, often have a student health services team that can assist you in determining local available healthcare provider options.
What Questions Should I Think About When Choosing A Provider?
Here are some considerations when choosing a provider:
- How long has the provider been in practice?
- Where did the provider receive training?
- Is the provider board certified?
- Has the provider diagnosed or cared for other women with bleeding symptoms?
- Is the provider someone you feel comfortable asking even the most private questions?
- Do the office hours work with your schedule?
- Is the office conveniently located near your home, school or work?
- Is the provider accepting new patients?
- Is the provider covered by your insurance?
How Do I Find A Provider?
Many women find a provider by contacting their insurance company and by getting recommendations from friends, family, or coworkers.
Through Your Insurance
Since it is so important to make sure your insurance covers the provider of your choice, it is often easiest to search for provider directly through your insurance company. You can do so by calling the number on your insurance card and most insurance companies have online listings of providers covered in their plans on their websites. Make sure you understand your particular insurance plan and ask about any related costs that seeing a specific provider might incur (premiums, copayments, deductibles, co-insurance, in-network versus out-of-network coverage).
While it is can be helpful to get feedback on health care providers from people you know, make sure the provider is covered by your insurance and meets all of the needs you specifically have.
What About Insurance?
Before making your appointment or visiting your doctor, it is important to find out what your insurance does and does not cover. Once you visit your doctor and find out more about any potential lab tests that need to be run or referrals, you may need to follow up with your insurance again to confirm coverage. Here are some potential questions to ask your insurance:
- Is the healthcare provider in network?
- Do I need a referral to see a specialist (i.e., a hematologist)?
- What services and/or lab tests require a preauthorization?
- Will my prescriptions be covered?
What Should I Bring To An Appointment?
It can be helpful to keep a health diary for a month or two by preparing answers to the questions below before visiting with your healthcare provider. This will help you and your healthcare provider in discussing what steps to take next.
- When did your symptoms begin?
- What lead to these symptoms?
- Make note of your energy level. When was it high? When was it low?
- How old were you when you had your first period?
- How many days do you have between the start of one period and the start of the next one?
- How many days does your period last?
- How many days do you consider your period to be heavy?
- How often do you have to change your pads or tampons?
- Do you have to double up on pads and/or tampons, especially at night?
- Do you experience pain during your periods? What makes them feel better? What makes them worse?
- Do your symptoms interfere with your daily life?
- Are you taking any prescription or nonprescription medications?
Your healthcare provider may ask you to track your menstrual flow (your period). It’s a good idea to track your flow even before you make that first visit. Tracking can be done easily using the chart below. So fill it out and remember to bring it with you to your medical appointment. The chart contains space for 10 days, but it is best to track for 30 days/1 month so that your healthcare provider can get a better picture of your bleeding. This chart will help you track your periods.
What Should I Ask My Doctor?
Being prepared for your doctor visit also means coming with a list of questions you may have for your provider about your symptoms and care. Make sure to come up with your own questions but here is a list of helpful ones to get you started:
- Will any diagnostic test be run? If yes, which ones? When would I find out the results?
- If lab work will be done, which lab is used? How can I find out it that lab is covered by my insurance?
- How can I manage my pain/symptoms while I wait for a diagnosis?
- Will I need to be referred to a specialist for testing and diagnosis?
- What if my labs don’t show anything?
What Is A Normal Period?
What is normal?
- A period (menstruation) usually lasts about 4 or 5 days, but one that lasts anywhere between 2 and 7 days is considered normal.
- A normal period occurs on average about every 28 days. Even if you go 21 to 35 days between periods, it is still considered to be normal. You should be able to use each pad or tampon for more than an hour, even on your heaviest days.
What is not normal?
Menstrual bleeding that lasts more than 7 days is considered heavy, and is called menorrhagia. It may be hard for you to tell if you have heavy bleeding because you have gotten used to it. Or perhaps your mother or other female relatives have told you that it’s normal to have heavy bleeding. But if you have any of the following signs, you might have menorrhagia:
- You use more than one pad or tampon every hour
- Need to double up by wearing one pad and a tampon because of heavy bleeding
- Need to change pads or tampons more than once during the night.
- Have a menstrual flow that repeatedly contains blood clots the size of a quarter or larger.
- Have a menstrual flow so heavy that it keeps you from doing the things you would do normally, such as going to work or school.
How To Manage Heavy Periods?
A heavy periods can be annoying and can sometimes interfere with activities you enjoy. But don’t let heavy periods affect the quality of your life. Until you are able to see your healthcare provider, here are some tips to help you cope with heavy periods.
- Use pads that are designed for heavy flow and have wings.
- Carry extra tampons, pads and undergarments with you during the “heavy days” of your period.
- Try the reusable menstrual cups that are available in many drugstores. They hold 3 times more blood than a super tampon.
- Avoid wearing white and light-colored clothing during your period.
- Wear a long shirt or keep a sweater or sweatshirt with you to wrap around your waist in case of leakage.
- Use a disposable heating pad that can be worn under your clothes.
- Do not take aspirin or NSAIDS (anti-inflammatory drugs), because they may increase bleeding. If you have cramps or back pain, acetaminophen can be a safer pain relief option. Talk to your healthcare provider to find a medication that is best for you.
- Lower or avoid salt, caffeine and alcohol in your diet.
- Try using a hot water bottle or heating pad.
- Drink plenty of water.
- Try to relax and get the proper amount of sleep.
- Eating a low-fat, high-fiber diet may help with cramps.
Many women with bleeding disorders have pain during their menstrual period that is more severe than normal cramps. This is called dysmenorrhea. Some women also feel pain in the middle of their cycle, between periods when one of the ovaries releases an egg. If you have excessive pain during or in between your periods, talk to your health care provider.
What Are Other Potential Causes For Heavy Periods?
There may be other reasons for heavy bleeding besides a bleeding disorder. Other possible causes for heavy periods include:
- Adenomyosis--presence of uterine lining tissue in the muscle wall of the uterus.
- Cyst--benign sac in the wall of the ovary or uterus that contains blood, fluid or other material.
- Ectopic pregnancy--a life-threatening pregnancy, in which the baby is growing outside the uterus.
- Endometrial hyperplasia—thickened endometrial lining of the uterus.
- Endometriosis--presence of uterine-lining tissue (endometrium) outside of the uterus
- Fibroids--noncancerous tumors of the uterus.
- Polyps--noncancerous growths on stalks in the endometrial lining of the uterus.
Heavy periods can also be caused by hormonal imbalances and other medical conditions including:
- Changes in hormone levels of estrogen or progesterone.
- Complications from hormone-releasing contraceptives (birth control pills, patches, rings, injections, intrauterine devices).
- Hyperthyroidism (overactive thyroid).
- Medications such as blood-thinning (anticoagulant) medications.