Are Heavy Periods Normal at 38? What Your Flow is Trying to Tell You

If you’re 38 and find yourself suddenly navigating a monthly scene that feels more like a flood than a flow, you’re probably asking one urgent question: Is this normal?

The short answer is: while exceptionally heavy periods are a common complaint for women in their late 30s and 40s, they are not something you have to simply “put up with.” They are often your body’s signal that something is out of balance.

Understanding the difference between a normal period at 38 and a sign of an underlying issue is key to taking control of your health and your comfort. Let’s dive into the reasons behind heavy bleeding and how you can find relief.

Why Now? The Perimenopause Connection

At 38, you are likely in the early stages of perimenopause—the transitional phase leading up to menopause. This isn’t about hot flashes yet; it’s about your hormones beginning to fluctuate unpredictably.

During this time, you may not ovulate every single month. When you don’t ovulate, your body doesn’t produce the hormone progesterone. Progesterone’s job is to stabilize the uterine lining and ensure it sheds evenly.

Without enough progesterone, the lining (endometrium) can build up thicker than usual. When it finally does shed, the result is a much heavier, often clot-filled period. This is one of the most common reasons for changes in period at 38.

Beyond Hormones: Common Causes of Heavy Periods

While hormonal shifts are the prime suspect, other conditions can cause or contribute to heavy menstrual bleeding (menorrhagia). It’s crucial to consider these:

1. Uterine Fibroids: These non-cancerous growths in the uterine wall are incredibly common, especially in your 30s and 40s. They can increase the surface area of the uterus or interfere with its ability to contract, leading to heavier and longer periods.
2. Adenomyosis: This condition is like endometriosis’ cousin. It occurs when the tissue that normally lines the uterus grows into the uterine muscle wall. This can cause the uterus to enlarge and result in severe pain and very heavy bleeding.
3. Polyps: Small, benign growths on the lining of the uterus (endometrial polyps) can cause heavy or irregular bleeding.
4. Thyroid Issues: An underactive thyroid (hypothyroidism) is a frequent culprit behind heavy periods and can emerge at any age.
5. Bleeding Disorders: In some cases, an underlying bleeding disorder that affects clotting can make menstrual flow excessively heavy.

How to Know If It’s “Too Heavy”: The Signs to Watch For

So, how can you tell if your flow is within the range of normal perimenopause symptoms or a red flag? Doctors often use the following criteria. Talk to your doctor if you:

• Soak through a pad or tampon every 1-2 hours for several consecutive hours.
• Need to double up on protection (e.g., a tampon and a pad) to prevent leaking.
• Pass large blood clots (the size of a quarter or larger).
• Bleed for more than 7 days.
• Experience symptoms of anemia, such as fatigue, weakness, shortness of breath, or pale skin.
• Need to change protection during the night.
• Find your daily activities are disrupted by your heavy flow and cramping.

Your Action Plan: What to Do Next

You don’t have to live with the exhaustion and inconvenience of heavy periods. Here is your step-by-step plan:

1. Start Tracking: For the next two cycles, keep a detailed log. Note the start and end dates, how many pads/tampons you use in a day (and how soaked they are), the presence of clots, and your pain level. This data is invaluable for your doctor. A simple notepad or a period tracking app can help.
2. See Your Doctor/Gynecologist: This is the most important step. Make an appointment specifically to discuss your heavy bleeding. Come prepared with your tracking notes and a list of your symptoms.
3. Ask About Testing: Your doctor will likely recommend tests to find the root cause. These may include:
   • Blood tests to check for anemia, thyroid function, and ovulation.
   • An ultrasound to look for fibroids, polyps, or adenomyosis.
   • A Pap smear or endometrial biopsy to rule out less common causes.

Treatment Options: There Is Hope

The right treatment depends entirely on the cause. Thankfully, there are many effective options:

• Hormonal IUD (Mirena): This is often a first-line treatment. It releases a small amount of progesterone directly into the uterus, which thins the uterine lining, dramatically reducing or even stopping bleeding.
• Other Hormonal Therapies: Birth control pills, patches, or rings can help regulate cycles and reduce flow.
• Tranexamic Acid: A non-hormonal prescription medication you take only on your heavy period days to help reduce bleeding by promoting clotting.
• Procedures: For structural issues like fibroids or polyps, minimally invasive procedures like a hysteroscopy can remove them.
• Supplements: If you are anemic, your doctor will recommend an iron supplement to help rebuild your energy.

The Bottom Line: Listen to Your Body

While heavy periods at 38 are a common part of the perimenopause journey for many women, they are not a life sentence. They are your body’s way of communicating.

Prioritizing your health means listening to these signals. By partnering with a healthcare provider, you can uncover the cause and find a solution that allows you to live your life fully, every day of the month – not just the “good” ones.