There are a lot of conversations you’re ready to have with your child when they begin puberty. Knowing about periods, including what to expect, is one of those conversations. But what happens when your child’s periods cause severe bleeding that negatively impacts their life? When they miss school and social experiences due to pain or an overly heavy flow?
UVA Health Children’s Adolescent Bleeding and Clotting Disorders program combines the expertise of our bleeding disorder and teen health experts. We’ll help your child understand what’s happening and talk about different options to reach their goals.
Treatment for Heavy Periods at UVA Health Children’s
For many families, the biggest question on their minds is whether their child needs to be seen. It can be hard to gauge what is, and isn’t, normal.
Who Should Be Seen?
If your child is complaining of heavy periods, it’s best to get them checked. Common symptoms include:
- Blood clots 1 inch or larger (the size of a quarter)
- Bleeding that feels like a gush (sometimes called flooding)
- Periods that last longer than 7 days
- Bleeding that frequently overflows sanitary products
- Pain that limits activities
- Periods that cause anemia or iron deficiency
- Periods that cause fainting or dizziness
- Needing to go to the emergency room
What Are Some Causes of Heavy Periods?
When young girls have periods that are heavy enough to impact daily life, there can be many causes. Sometimes the problem is related to a hormonal imbalance. Sometimes it’s related to a bleeding disorder. For many, overly heavy periods can be the first sign of a serious bleeding disorder.
At our appointment, we'll talk about how to best find the cause. Some methods we may use are:
Lab work
Lab work can give us many valuable insights about your child’s condition. We can see if their blood count is changing, what their platelet count is, and hormone levels.
Family history
Many of the conditions that cause heavy periods run in families. Sometimes a family history can help us exclude, or include, tests for these conditions.
Genetic testing
Some conditions, like hemophilia and some connective tissue disorders, can be found through genetic testing. If we have reason to suspect that, we can refer your child to our genetics department for testing.
Abdominal ultrasound
Structural differences in the uterus or ovaries can also cause heavier periods. With an abdominal ultrasound, we can check for these changes.
Conditions We See
- Hemophilia
- Bleeding disorders
- Von Willebrand disease
- Eating disorders
- Autoimmune diseases, like lupus
- Connective tissue disorders, like Ehlers-Danlos
- Polycystic ovarian syndrome
- Thyroid disorders
- Clotting disorders
- GI disorders, like Crohn's
- Diabetes
What Treatments Are Available?
Sometimes, we aren’t able to find an underlying cause. That doesn’t mean that your child can’t receive treatment. We can talk through the available options.
Hormonal Medications
When we’ve either found or suspect a hormone imbalance, we can use medications to help your child’s hormones regulate. This regulation leads to more predictable periods. It can also reduce bleeding.
Medications to Improve Clotting
Sometimes bleeding is related to blood’s inability to clot. But medications like tranexamic acid can help blood clot and reduce bleeding. These medications only need to be taken during your child’s periods, not daily.
Factor
Many bleeding disorders are related to a lack of a blood clotting factor. Factor infusions can help in these situations.
As a federally funded hemophilia center, we’re able to help our patients get medications like factor, and can offer the full range of treatments.
Supplements
One of our focuses is helping your child to feel better. If their period is leading to iron deficiency, they might feel weak, tired, or have trouble recovering from illnesses. Iron supplementation can help.
In addition to helping find an oral supplement, we can also provide IV iron if your child has a condition that affects iron absorption.
Long-Term Hormone Replacement
For young girls, remembering to take daily medication can be challenging. Long-term options like IUDs and implants are also available. These can be done with sedation or without, based on your child’s comfort.
Menstrual Suppression
For some patients, the goal is to stop the menstrual cycle entirely. That’s especially true if their menstrual cycle is also causing headaches, chronic pain, or POTS symptoms. By suppressing the menstrual cycle, we can often prevent these issues.
Other Ways We Can Help
When your child’s menstrual cycle has caused problems that affect their entire life, we need comprehensive solutions. Thanks to our interdisciplinary team, we’re able to provide supportive care.
Social work
Can help with things like transportation, figuring out financial assistance, and social issues.
Interpreters
Talking about period problems can be hard when you’re speaking in your first language. With interpreters, we can make sure you’re not also having to translate into a second one.
Psychologists
Your first period can be a lot emotionally even when it isn’t trying to kill you. With the help of psychologists, your child can start to process what this means for them.
Educational Consultants
Sometimes, even with treatment, your child may end up missing some school. They may also need ongoing accommodations, like additional time between classes.