A menstrual period without ovulation — a common occurrence in adolescents — can be quite heavy as they are bleeding solely because the uterus lining has outgrown the blood supply.

Story by: Norton Children’s on July 26, 2021

A menstrual period without ovulation — a common occurrence in adolescents — can be quite heavy as they are bleeding solely because the uterus lining has outgrown the blood supply.

“This is the reason why you have cycles that are every 21 to 45 days, and they might be a little bit heavier and might last a little bit longer than usual. This is very common the first three to five years after periods start,” Kimberly S. Huhmann, M.D., pediatric and adolescent gynecologist at Norton Children’s Gynecology, affiliated with the UofL School of Medicine, said during a recent continuing medical education opportunity.

After three years, nearly all periods are tied to ovulation and will become more regular.

The child’s age at the time periods start affects when cycles become ovulatory. If periods start at an earlier age, the time to ovulatory cycles is shorter. If periods start later, the time to ovulatory cycles — when an egg is released — may take a little longer.

Heavy bleeding is not to be taken lightly. About a fifth of patients with heavy, regular bleeding have a bleeding disorder. Your child’s gynecologist may order lab tests to make sure, especially in the following circumstances:

• Periods that last longer than seven days associated with flooding or gushing or bleeding through a pad or tampon within two hours
• History of anemia
• Family history of a bleeding disorder
• History of excessive bleeding after surgery or dental procedures

If a child is having heavy, ovulatory periods and a bleeding disorder has been ruled out, there are hormonal treatment options such as estrogen and progesterone, as well as nonhormonal options. Ibuprofen the night before the period and continuing through the first few days can reduce flow by up to 80%.