We received an email from a mother who hoped that our period underwear would be the lifesaver for her daughter who has a heavy period and often has to change her sanitary pads after breakfast because otherwise she would leak.

What an impact such a heavy menstrual period must have on the lives of the girls and women who experience it every month. One in five women between the ages of 35 and 55 experiences it, which is truly devastating.

I wonder what about heavy menstrual bleeding (HMB) in young women between the ages of 11 and 35 in the context of the campaign month Bloedserieus ?

Recent research by WOMEN Inc and Motivaction shows that 77% of women who menstruate experience serious symptoms. Based on this research, WOMEN Inc presented the Manifesto on Menstruation and Hormone-Related Complaints to the Minister of Health, Welfare and Sport (VWS) on September 27, 2022. It appears that young girls, in particular, don't go to a doctor with their symptoms because they think it's just part of life. Their mothers, aunts, and grandmothers had it too, so it's probably just part of life. Serious symptoms can indicate a medical condition, but much research still needs to be done. Doctors are sometimes completely unaware of what's going on, and also unaware that many girls stay home for a few days each month because the heavy bleeding is inconvenient, exhausting, and painful. This exhaustion is caused by iron deficiency anemia.

I remembered that I used to have a friend Nathalie who, every month, with a pale face and greasy hair, would lock herself up at home for a few days to get through the worst days of her period.

I visited her again and asked Nathalie if she went to the doctor. No, I never went. My mother used to have it so bad, so her standard solution was a hot water bottle on her stomach and in bed. "It'll go away on its own." I often had blisters on my stomach, because only when the hot water bottle was really hot did I feel any pain. I was occasionally given two paracetamol, but only in exceptional cases. There wasn't Feminax back then, which I took when I was older. It took away the worst of the pain, but not all of it. I also started the pill at 18, and that helped too.

“I often had blisters on my stomach because I only felt no pain when the hot water bottle was super hot.”

In our youth, it was still taboo to talk about these kinds of problems in public, and I think that played a role in not going to the doctor. On the other hand, I was raised in a way that you just had to grit your teeth. As they say: "It'll go away on its own." And it did. After a day, the pain was gone. The heavy bleeding usually only lasted one or two days.

I still had some questions for Nathalie, my friend with experience.

How seriously did you take your heavy periods as a teenager?

Serious in the sense that I knew it was a given and I had to prepare for it. Every month. One month was always worse than the next. Alternating, but every single time was terrible. I always thought it was normal. That every woman had their period this way. I didn't know any better.

Did you tell your teachers or colleagues what was going on? Did you call in sick?

I used to miss school sick when I got my period on that day. I just couldn't handle it.

Of course, I did call in sick then, but I can't remember if I told them what was wrong. When I started working, I rarely called in sick for that reason. I certainly can't remember. But I wasn't quick to call in sick anyway. I would sometimes sit at work sweating and gritting my teeth in pain. I did tell my closest female colleagues. At least then they knew what was going on. At that age, I usually got better by the afternoon, so I could function optimally again.

“Have you gotten any special, crazy, or interesting reactions or anything like that from people?”

Reactions at home were always neutral. "Oh, it's that time again. Go to bed, I'll make you a hot water bottle."

I was fine with that too. It was what it was, I figured, so I wanted nothing more than to lie in bed. Because I didn't talk about it any further, I naturally didn't get any reactions.

Only later, when I mentioned it, did I realize that none of my friends (young or old) suffered as much as I did. My friends' reactions were always sympathetic, but never shocking. More along the lines of, "Oh, that must be awful. I'm glad I didn't have that." Which I completely understand.

The times when I called in sick at secondary school because I couldn't cope anymore, I still had to cycle home for 45 minutes

I remember that so well. Such traumatic memories. I specifically remember one ride where I was wearing white pants. You guessed it: that didn't end well. A big red spot, and I didn't even dare stop at the traffic light because people would see it. At home, I crawled into bed crying (with a hot water bottle). The next day, I almost didn't dare go to school. What if it happened again? Of course, I went anyway and just put on dark pants...

At home, I crawled into bed crying (with a hot water bottle). The next day, I almost didn't dare go to school. What if it happened again?

I'm impressed. You start your period somewhere between the ages of 11 and 15, and then every month you feel incredibly weak for a few days and bleed so heavily that you're afraid to leave the house because you might leak. I'm allowed to quote Dr. Heleen van Ommen, a pediatric hematologist at Erasmus MC Sophia Children's Hospital, from an earlier interview she gave.

The main cause

"The main cause of heavy menstrual bleeding in teenagers is what are known as anovulatory cycles," she explains. "This means that vaginal bleeding occurs without ovulation. During puberty, hormone levels aren't fully regulated, meaning ovulation often doesn't occur. As a result, progesterone isn't produced, and the uterine lining doesn't stop growing. For a quarter of girls, this leads to heavy menstrual bleeding. This can last for one to two years."

For a quarter of girls, this leads to heavy menstrual bleeding. This can last for one to two years.

Heleen van Ommen, the pediatric hematologist, emphasizes the importance of seeing a general practitioner and ensuring you are taken seriously and referred to the appropriate outpatient clinic. This could be a gynecologist, but also a hematologist.

The Erasmus MC Sophia Children's Hospital offers consultations twice a month for young women up to 25 years old with heavy menstrual bleeding. You need a referral from your GP. Van Ommen: "Then I can check for a clotting disorder, the nurse can diagnose and treat any anemia. And the gynecologist can recommend the contraceptive pill after verifying there's no gynecological cause." While the bleeding can be reduced by taking the pill, there are other options.

In practice, Van Ommen sees that girls and their parents often find it nerve-wracking to start the pill. "Because people see it more as contraception. You can also start with just tranexamic acid. For some girls, that helps enough."

What exactly is heavy menstrual bleeding (HMB)?

Heavy menstrual bleeding has several causes. The amount of menstrual blood depends, among other things, on the thickness of the uterine lining (the inner lining of the uterus).

You can recognize hmb by:

• A shorter cycle (usually around 21 days),
• A longer menstrual period of 7 days or more,
• Heavy blood loss, think of ¾ lemonade glass or more (instead of 5 tablespoons),
• Loss of clots,
• cramp,
• Fatigue due to iron deficiency.

Heavy menstrual bleeding can be the result of another medical condition. Heavy periods are common with a clotting disorder, but endometriosis, adenomyosis, PCOS, and infections, for example, can also cause heavy periods. To rule out (or diagnose) these causes and prevent unnecessary health problems, it's always important to have a medical evaluation for heavy periods. Treatment options can then be discussed immediately.

To draw attention to this problem, November has been declared the "Blood Seriously" campaign month. https://www.hevigbloedverlies.nl/bloedserieus

Moodies has also introduced period underwear for girls and women with heavy periods .

This one has "super" absorbency and can hold between 25 and 30 ml of blood. We realize this isn't a full-day solution for girls and women with extremely heavy periods, but we hope our new boyshorts can help more girls and women with heavy periods.

These boyshorts are also wonderful to sleep in, especially because the absorption continues at the back and front.

Sources: Period.nl / Bloedserieus – Heavy bleeding / doq.nl / WomenInc