{Guest Post} Heavy Menstrual Bleeding: Signs, Symptoms and Treatment

First of all, thanks to the wonderful staff at The DivaCup for allowing me to guest blog this week! The DivaCup is a fabulous way for women to measure and cope with their flow. Thanks again!

Now on to the topic at hand …

The curse. Aunt Flo. Big Red. Whatever you call it, bleeding once a month is what we do as women, whether we like it or not.

For some of us, menstruation is nothing more than an annoying, inconvenient, sometimes painful reminder of our potential to make a baby, while for others, like me, and millions of other women around the world, menstruation was, or is, a bloody nightmare that can lead to heavy, or abnormal, uterine bleeding.

  • Imagine wearing an adult diaper, a superplus tampon and an overnight pad while chairing an executive board meeting.
  • Imagine meeting your future husband’s best friends for the first time and leaving a red stain on their expensive white chair when you stand up to leave.
  • Imagine sleeping on an air mattress on your bedroom floor three nights each month to avoid leaking blood all over your mattress.
  • Imagine leaking blood into your shoes when you stand up to greet a new client for the first time.
  • Imagine being told your life could be in danger if you have one more period like the one you had the month before.

The UnHysterectomy: Solving Your Painful, Heavy Bleeding Without Major Surgery

These are not fictitious accounts created for dramatic effect or to capture attention; they are true stories I experienced myself, or heard from women who spoke with me for my book, The UnHysterectomy: Solving Your Painful, Heavy Bleeding Without Major Surgery.

What amazes me most about the stories women have shared with me is that every one of them, without exception, thought their pain and bleeding was normal, something they “just had to put up with.”

Some suffered for as long as seven to 10 years without seeking treatment, or were told by their doctors and gynecologists that it was “all in their head”.

Here’s a news flash, gals – it’s not normal to bleed that much!

Heavy menstrual bleeding, now a medically-accepted clinical term under new treatment guidelines published by the Canadian Society of Obstetricians and Gynecologists (SOGC) and the American College of Obstetricians and Gynecologists (ACOG), is “the direct cause of a significant health care burden to women, their families and society as a whole” affecting up to 30 percent of women of reproductive age.

In Canada, heavy menstrual bleeding is now defined as “excessive menstrual blood loss which interferes with the woman’s physical, social, emotional and/or material quality of life … can occur alone or in combination with other symptoms.”

What can influence our periods?

  • Hormones
  • Stress
  • Being overweight or underweight
  • Exercising too much
  • Certain medications and
  • Certain health conditions

What causes heavy menstrual bleeding?

With the exception of certain conditions such as ovarian, uterine or cervical cancer, which can produce abnormal uterine bleeding even after menopause, most heavy menstrual bleeding can be attributed to other, more benign conditions such as:

  • Fibroids (non-cancerous tumours, what I had). Fibroids account for more hysterectomies in Canada than any other disease.
  • Adenomyosis (thickening of the uterus)
  • Endometriosis (where uterine tissue grows outside the uterus)
  • Polyps (benign masses)
  • Cysts
  • Polycystic ovary disease
  • Uterine hyperplasia (when the lining of the uterus becomes too thick) and
  • von Willebrand disease

Signs and Symptoms

No two women menstruate alike so it’s very difficult to quantify exactly what constitutes heavy menstrual bleeding. The SOGC has published definitions on page S6 of its new guidelines, published in the May issue of the Journal of Obstetrics and Gynecology, which you can download here.

Generally speaking, however, here are some signs and symptoms of heavy menstrual bleeding to watch for:

  • Having to change your pad or tampon every hour or filling a menstrual cup every 2-3 hours.
  • Soaking through your bedclothes, pyjamas, clothing or upholstery
  • Spending more than usual amounts of money on supplies every month
  • Passing clots
  • Gushing blood upon standing
  • Changing your social or work schedule to accommodate your period
  • A feeling of fullness in your belly
  • Anemia
  • Chronic fatigue
  • Difficulty concentrating or understanding things
  • Bleeding past menopause (if this is the case, you MUST see your doctor IMMEDIATELY)


In 2013, thanks to an explosion in high technology and medical breakthroughs in new diagnostics and drug therapies, women suffering from heavy menstrual bleeding have a full range of treatment options that do not necessarily end in hysterectomy.

From least invasive to most invasive, some of the treatment options are:

  • Watchful waiting
  • Birth control
  • Hormone therapy
  • Surgery, including myomectomy, endometrial ablation, uterine artery embolization (difficult to find in Canada) and focused ultrasound (starting to become more available thanks to trials being conducted at Sunnybrook Hospital in Toronto)
  • Hysterectomy

Choose Wisely

Not every gynecologist will tell you the full range of treatment options available (nor are they familiar with all of them) as I discovered first-hand in my own journey, and through multiple interviews I conducted for my book.

As women, we sometimes need to advocate for ourselves and shop around until we find a physician who can offer us the treatment options that WE want, not the ones THEY are willing to perform.

Unfortunately there are physicians in this country who are not fully aware of all the treatment options, or simply do not know how to perform less invasive procedures.

Ask and you shall receive.

I can’t tell you the number of women who have read my book and are being empowered with new knowledge were able to advocate for better menstrual care at their doctor visits. It was very empowering for them and very rewarding for me.

Final Thoughts

If you suspect you have heavy menstrual bleeding, pick up the phone right now and call your family doctor for your first appointment, or go direct to a gynecologist if you live in the U.S. where referrals from family doctors are unnecessary.

  • Early diagnosis is key
  • Stop telling yourself all that blood is normal

As I also say in my book, a fabulous way to measure your flow is to use a device like The DivaCup to measure how much blood you’re losing on a daily basis.

Want to get pregnant?

My absolute closing thought is devoted to those younger women who want to solve their heavy menstrual bleeding, but still want to get pregnant. Please know that some of the treatments I have mentioned, such as ablations, are only for women who are past having children.

Having said this, there are many other treatments that can remove your fibroids while preserving your fertility and you simply MUST ask about them before agreeing to any major surgery.

If you’d like some proof, check out Shannon’s story on my website and you’ll see what I mean.

Disclaimer: The information and opinions expressed herein are not a substitute for the advice of a physician. Only your doctor or a qualified health provider can provide you with advice and recommendations for your situation. This post and the book, The UnHysterectomy: Solving Your Painful, Heavy Bleeding Without Major Surgery. presents information that has been researched and written by a patient for patients. Some of the testimonials contained within the book are composites to protect the privacy of those interviewed. Medical experts have reviewed the medical information for accuracy; however, the information provided should not be used as the sole source of information regarding hysterectomy and its alternatives. Every attempt has been made to present a balanced account of this issue. Any errors or omissions are unintentional. Holly Bridges, her heirs, administrators, successors, agents and assigns, cannot be held liable for injury or damages resulting from use of the information provided in this blog post and the referred to publication.


Holly Bridges Author of UnHysterectomy: Solving Your Painful, Heavy Bleeding Without Major SurgeryHolly Bridges: Author

Holly Bridges is a patient, author and advocate for minimally invasive gynecology and alternatives to hysterectomy. She spent 15 years as a CBC Radio and Television journalist and talk show personality across Canada and is an accredited public relations practitioner with 30 years of experience in the field of journalism and communication. She has won five awards for her writing. The UnHysterectomy: Solving Your Painful, Heavy Bleeding Without Major Surgery is her first book.



Dr. Sony S. Singh is the Director of Minimally Invasive Gynecology at the Shirley E. GreenbergWomen’s Health Centre at The Ottawa Hospital in Ottawa, Ontario.

Dr. Sony S. Singh, Medical Editor

Dr. Sony S. Singh is the Director of Minimally Invasive Gynecology at the Shirley E. GreenbergWomen’s Health Centre at The Ottawa Hospital in Ottawa, Ontario. He is also an Assistant Professor in the University of Ottawa Department of Obstetrics and Gynecology. Dr. Singh is known for his surgical expertise in treating deep infiltrative endometriosis through minimally invasive means and is a leading expert in the field of laparoscopic (keyhole) hysterectomy. He also specializes in minimally invasive alternatives to hysterectomy and has also helped develop a new index known as technicity to measure the appropriateness of hysterectomies being performed in Canadian hospitals and to encourage gynecologists to perform the procedure less invasively, either vaginally or laparoscopically. Dr. Singh has achieved one of the highest technicity rates in the world.


Diva Summer Tips

patio photoEvery Monday, our Diva Team gets together for a staff meeting. We go over department highlights and projects and then end with some highlights of the weekend. With summer, the weekend highlights abound and so we thought to share some of our summer highlights and tips with the Diva Community.

Summer moments range from those that keep you super busy, to those that let you be a bit lazy and of course those that you never want to end. Whether at home with the kids, on the patio with friends or out for a summer run, we’ve got some summer tips that will help you make this summer one to remember!

Nancy: Summer Sips

Ah… Summer! Beyond the sunny weather, the outdoor activities and the sandals, I love refreshing summer drinks! With seasonal colorful fruits and fragrant herbs, you can make any drink an instant favorite – from the kids to your girlfriends.

Here are some of my Diva Tips for a refreshing summer:

  1. When you buy seasonal fruits, set some aside. Wash and cut them (if needed) and freeze them flat in your freezer. Once frozen, put them in a resealable bag where they will be ready to jazz up any drink from sparkling water to sangria!
  2. Do you have basil left over from a recipe? A garden overrun by mint? No problem! Herbs are perfect to turn ordinary water into a refreshing nectar. Simply put your herbs in a pitcher, fill it with water and give it a little bit of time to infuse. Voila! Feeling adventurous? Try these winning combinations: Watermelon & Rosemary, Cucumber & Mint or Blackberry & Sage.
  3. Why does an “umbrella” drink taste so good? It’s all about presentation of course! Unleash your creativity this summer and give your stemware a Diva makeover. Colorful straw or ribbon around glasses or the oh so popular mason jar are all great ideas when serving your guest a drink. Go ahead, think outside the box! My personal favorite: Take a small, fancy food skewer, slide a couple a colorful fruits & herbs and set the skewer across the rim of the glass, Enjoy!
John – BBQ Tips

One of my favourite parts of summer is the opportunity to get much more use from my grill. Nothing beats the taste of food grilled outdoors.

Over the years, I have prepared many great meals on the grill, and some not so great. I have picked up some tips that can help make for a more successful meal.

  1. Clean the grill. It only takes a few minutes before and after, but cleaning the grill helps make cooking easier and helps to reduce flare-ups.
  2. Heat the grill before you put your food on. I always pre-heat the grill nice and hot, at least 500 degrees Fahrenheit (°F). This helps to lock in juices and flavor as meat cooks.
  3. Always use tongs. Better than a fork, tongs making moving food easier. Also, tongs do not pierce the food which can let juices run out.
  4. Flip food only once. If you are cooking meat on the grill, avoid flipping it more than once. Flipping meat many times, can drive moisture out of the food causing it to dry out.
  5. Use a meat thermometer to check when food is done. Always be safe and use a meat thermometer to make sure you cook food to the proper internal temperature, and not overcook.
  6. Let grilled meat sit for five minutes before you cut it. Letting grilled meat stand for 5 minutes after removing it from the grill helps to keep juices in. Cutting meat right after removing it causes the juices to run out.
  7. Cook for family and friends. I find life far more fun and enjoyable when you can cook for family and friends! Invite someone over and enjoy a meal together.

Have fun this summer with your grill.

Francine: Patio Pleasantries

Our Canadian winters can be very long and our summers are too short. So as soon as we get sunny weather, I spend as much time outside as possible.

I really enjoy gardening and entertaining outside “Al Fresco” is one of my favorite.

I love to set up a nice table with a colorful table cloth, dishes, glasses, candles and always enjoy making a flower arrangement from flowers and plants growing in my garden.

My guests always have a great time enjoying the food and watching the stars.

Nina: Healthy Summer Tips

After months of dreary winter days, it feels great to welcome summer with BBQ get togethers and taking your workouts outside. There are so many workout variations during the summer months that are welcome ways to refresh your routine. Many local parks and conservation areas have kayak or canoe rentals, bike trails and walking paths and are great ways to get active with friends and family. Initiate some outdoor volleyball or to help beat the heat, crank up the sprinkler and connect with your inner child.

Don’t forget to hydrate before, during and after any workouts.

Eating right can be a challenge with traditional BBQ fare. While nothing beats the convenience, taste and smells of the BBQ, there are so many recipes available to make your mealtime healthier and still satisfying. Of course, my favorite way to top off a great day and meal is with a sweet treat. While the sounds of the ice cream man can get anyone running, try a fresh fruit smoothie, homemade popsicles, or my favorite, Yonanas!

No matter what your summer plans, I hope you incorporate some fun outdoor fitness and try something new on the menu to keep healthy.

Carinne: Mommy Tips!

For every parent, it can be overwhelming to keep the kids busy once school is out. Although it takes a little bit of planning, creating great summer memories can be fun and easy. Lately I’ve been turning to Pinterest to find some inspiration.

There’s unlimited ideas for inexpensive fun activities.

The kids will love these paper bag wind socks and gives us an excuse to use some extra party streamers.

My kids are huge fans of frozen treats and I was excited to come across this recipe for homemade strawberry creamsicles (and they’re healthy too!). I substituted the honey for agave syrup and they were a hit! We will definitely be making these again! There’s even a recipe for strawberry watermelon coolers for the adults which sounds like it’s worth a try.

A creative use for the watermelon rinds are these watermelon boats. I think this will be a fun activity on a hot day. Hopefully the boats will float and we can get some fun races going!

Amongst all the summer fun, we will definitely be planning some much needed date nights and get togethers with friends (without the kiddos!). Parents need a break too sometimes!

Share your Diva Summer Tips with the Diva Community today and don’t forget to visit our Facebook page every Monday for our Diva Summer Moments!