Worried that your periods are heavy but aren’t sure what to do next? Nicole Jardim shares her own personal experience and steps to take when trying to treat heavy periods.

As a teenager, I had the kind of periods that were guaranteed to leak through my school uniform. The kind that made me sleep with a thick towel under me so I didn’t leak onto the sheets, and the kind that had me rushing to the bathroom every few hours to change pads and tampons.

It turns out, I’m not alone in my experiences.

According to the American College of Obstetricians and Gynecologists, roughly one-third of American women seek treatment for heavy periods. If there’s one thing I took away from my experience, however, it’s that treating your heavy flow isn’t enough. You also need to treat the underlying cause.

If you’re experiencing heavy periods and want to learn about next steps, I’ve provided an overview of what defines a heavy period, causes of heavy periods, and how to treat them, below.

Menstrual cycles, or periods, are defined as bleeding that lasts for three to seven days, and occurs every 25 to 35 days, with an average blood loss range of 30 to 50 milliliters.

To give you a visual, each soaked regular pad or tampon holds roughly 5 milliliters of blood. So, it’s totally fine to soak 6 to 10 pads or tampons during your period.

A variety of signs may indicate a heavier than average flow, also known as menorrhagia. These signs include:

  • a period that lasts longer than seven days
  • losing more than 80 milliliters of blood (5.5 tablespoons or 2.7 liquid ounces) per cycle
  • soaking more than 16 regular tampons or pads per cycle
  • flooding, or when your pad or tampon is soaked through within 30 minutes
  • clots that are the size of a quarter or bigger
  • having to change pads or tampons during the night

If you’re concerned about your period flow, or are experiencing any of the symptoms listed above, you should speak with your doctor.

The causes of menorrhagia are not entirely clear, but it’s thought that the following could contribute to or cause it:

If you make an appointment with your doctor for an exam of your heavy periods, they may perform the following tests:

  • Pelvic exam. Your doctor will want to determine if there are any physical issues. This should also include a pelvic ultrasound to check for fibroids and endometrial thickness.
  • Endometrial biopsy.There may be a need for other procedures, such as an endometrial biopsy, to determine the presence of endometrial hyperplasia, uterine cancer, or infection. This is where a small piece of the uterine lining is removed.
  • Saline infusion sonohysterogram (SIS). Another procedure, known as a SIS, might also be conducted to get a 3-D view of the uterine cavity.

If you’re still concerned, I recommend that you request a few alternative tests to rule out other potential conditions:

  • full thyroid panel, especially because thyroid disease is a common cause of heavy periods
  • pregnancy test
  • sexually transmitted infection (STI) tests
  • complete blood count and full iron panel (serum iron, transferrin, ferritin, and total iron binding capacity [TIBC]) to determine if you have anemia

If you’ve had heavy periods since your teen years, I’d also recommend getting tested for von Willebrand disease, a blood coagulation disorder. Make sure to get copies of all the test results for your records.

Ultimately, how you treat your heavy periods will rely on your diagnosis. That said, a few conventional treatments for heavy periods include:

  • Birth control pill. This is best used as a short-term solution while you’re still addressing the underlying cause.
  • Mirena IUD. This is another short-term solution, which is a form of birth control that releases progesterone.
  • Dilation and curettage.This is a minor surgery where your doctor dilates your cervix and removes tissue from your inner uterine lining with a curette.
  • Tranexamic acid. This is used to stop heavy bleeding in more urgent situations when a woman has been bleeding non-stop.

Other more permanent solutions include endometrial ablation and a hysterectomy, which might not be ideal solutions if you’re looking to conceive in the future.

If you’re looking for at-home remedies that might help ease the bleeding, tryincreasing iron-rich foods or taking an iron supplement.Iron actually helps to make periods lighter and addresses iron-deficiency anemia caused by heavy periods.

Foods high in iron include:

  • beef
  • bison
  • liver
  • turkey

You can also add vitamin C to your diet.This vitamin is important in helping to prevent and treat anemia because it helps improve the absorption of iron.

You can find vitamin C in:

  • bell peppers
  • tomatoes
  • citrus fruit
  • strawberries
  • mango

Heavy periods are often a symptom of an underlying disorder. It’s important to address them with your doctor, not just to get the bleeding under control, but also to help you treat the condition that may be causing it.

It’s also important to remember that not all treatment options are a one-size-fits-all experience. So if you find that it takes multiple efforts to find the best treatment for you, don’t get discouraged.

Nicole Jardim is a certified women’s health coach and the creator ofFix Your Period, a series of programs that empower women to reclaim their hormone health using a method that combines simplicity and sass. Her incredible work has impacted the lives of hundreds of thousands of women around the world in effectively addressing a wide variety of period problems, including PMS, irregular periods, PCOS, painful periods, amenorrhea, and many more. Nicole is also the co-host of “The Period Party,” a top-rated podcast on iTunes — be sure to tune in if you want to learn more about how to fix your period. She’s also the creator of the Institute for Integrative Nutrition’s hormone health continuing education course.Take Nicole’s Period Quiz to get a custom report based on your unique physiology and discover what’s up with your period!