Why do I bleed more than most people? Understanding the causes of excessive bleeding

October 1, 2025 •

5 min read

Von Willebrand disease (VWD), the most common inherited bleeding disorder, affects up to 1% of the U.S. population, though many cases remain undiagnosed. If you find yourself asking why do I bleed more than most people, it could be a sign of a manageable medical condition that warrants investigation.

Quick Summary

This article explores the common causes of excessive bleeding, including genetic disorders, hormonal imbalances, gynecological conditions, and medication effects. It details key symptoms and outlines when to consult a healthcare provider for proper diagnosis and care.

Key Points

Abnormal Bleeding Indicators: Watch for periods lasting over seven days, soaking through pads/tampons hourly, quarter-sized or larger clots, easy bruising, or prolonged bleeding after minor cuts.
Genetic Disorders: Inherited conditions like von Willebrand disease and other clotting factor deficiencies can cause lifelong bleeding problems.
Gynecological Causes: Heavy menstrual bleeding, or menorrhagia, is often caused by uterine fibroids, polyps, or hormonal imbalances.
Medication Effects: Common drugs, including blood thinners (anticoagulants) and NSAIDs, can significantly increase the risk of bleeding.
Underlying Diseases: Systemic issues such as liver disease, kidney disease, and vitamin K deficiency can impair your body's ability to clot blood properly.
Seek Medical Advice: Persistent concerns about bleeding should prompt a doctor's visit for a proper diagnosis, which may involve blood tests and imaging.

For many, what constitutes “heavy bleeding” is subjective, but medical guidelines provide clear indicators. Blood loss that disrupts daily life, lasts longer than a week, or involves soaking through sanitary products frequently is a sign that something is amiss. Understanding the root cause of excessive bleeding is the first step toward effective management and peace of mind. A wide range of factors, from inherited conditions to medication side effects, can play a role.

What is Considered Abnormal Bleeding?

Not all heavy bleeding is cause for alarm, but certain symptoms indicate it's time to seek medical advice. Knowing the signs can help you advocate for your health and get an accurate diagnosis.

Heavy Menstrual Bleeding: For many women, excessive bleeding during their period, also known as menorrhagia, is a key concern. This can manifest as soaking through pads or tampons every hour for several consecutive hours, passing blood clots larger than a quarter, or experiencing periods that last longer than seven days.
Easy Bruising: Unexplained, large, or frequent bruising with minimal or no injury is a significant red flag. This can indicate an issue with your blood's clotting ability.
Prolonged Bleeding: If you notice bleeding that takes an unusually long time to stop after minor cuts, dental work, or surgery, it is a sign that your coagulation system may be impaired.
Other Symptoms: Unexplained nosebleeds lasting longer than 10 minutes, bleeding from the gums, or signs of anemia (such as fatigue, weakness, or shortness of breath) can also be related to a bleeding issue.

Genetic Bleeding Disorders

Inherited bleeding disorders are a common reason for excessive bleeding. These conditions are caused by deficiencies or defects in the proteins, known as clotting factors, that are essential for blood coagulation.

Von Willebrand Disease (VWD)

VWD is the most common inherited bleeding disorder and occurs in both men and women, though women may notice symptoms more often due to menstruation. It is caused by low levels of von Willebrand factor (VWF), a protein that helps platelets stick together and carry another important clotting protein, factor VIII.

Other Factor Deficiencies

Less common but more severe inherited disorders, such as hemophilia (types A and B), involve a deficiency in specific clotting factors like factor VIII and IX, respectively. Other rare factor deficiencies, such as those affecting factors I, II, V, VII, X, XI, and XIII, can also cause bleeding problems.

Heavy Menstrual Bleeding (Menorrhagia)

While it is often the most noticeable symptom for women, menorrhagia itself can be a sign of an underlying gynecological problem, not just a stand-alone issue.

Common Causes of Menorrhagia

Uterine Fibroids: These are non-cancerous growths of the uterus's muscle tissue. Their size and location can cause heavier and more prolonged periods.
Endometrial Polyps: Small, benign growths on the uterine lining can cause heavy or irregular bleeding between periods.
Hormonal Imbalances: An imbalance between estrogen and progesterone can lead to a thickened uterine lining, resulting in heavy bleeding when it sheds. Conditions like polycystic ovary syndrome (PCOS) can cause this imbalance.
Adenomyosis: This condition involves the uterine lining growing into the muscular wall of the uterus, leading to heavy and painful periods.
Intrauterine Device (IUD): A non-hormonal IUD can cause heavier menstrual bleeding, especially during the first few months after insertion.

Medications That Increase Bleeding

Certain medications are known to interfere with blood clotting and can increase the risk of bleeding. If you are taking any of these drugs, it's crucial to discuss the risk with your doctor.

Anticoagulants (Blood Thinners): Medications like warfarin (Coumadin), apixaban (Eliquis), and rivaroxaban (Xarelto) are designed to prevent blood clots, but can increase bleeding risk.
NSAIDs: Over-the-counter pain relievers like aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) can have a blood-thinning effect.
Certain Antidepressants and Antibiotics: Some classes of these drugs can affect platelet function or vitamin K metabolism, influencing clotting.

Other Medical Conditions Affecting Clotting

Liver and Kidney Disease

The liver produces many of the body's clotting factors. Severe liver disease, such as cirrhosis, impairs this function and can lead to bruising and excessive bleeding, often from esophageal varices. Similarly, kidney disease can affect platelet function and increase the risk of bleeding.

Vitamin K Deficiency

Vitamin K is essential for the production of several clotting factors in the liver. A severe deficiency can cause uncontrolled bleeding. While this is rare in adults, it is a significant concern for newborns, who are routinely given a vitamin K shot at birth to prevent a condition known as vitamin K deficiency bleeding (VKDB).

Comparison of Bleeding Triggers


Cause	Mechanism	Typical Onset	Related Symptoms	Bleeding Severity
Von Willebrand Disease	Low or dysfunctional von Willebrand factor, affecting platelet adhesion.	Present from birth (inherited).	Heavy periods, nosebleeds, easy bruising.	Varies from mild to severe.
Uterine Fibroids	Benign uterine growths that disrupt the uterine lining.	Childbearing years.	Heavy, prolonged menstrual bleeding.	Often heavy.
Blood Thinners	Medications that interfere with the clotting cascade.	After starting medication.	Bruising, prolonged bleeding from cuts.	Varies based on medication.
Liver Disease	Impaired production of clotting factors in the liver.	Adult onset (acquired).	Easy bruising, internal bleeding (e.g., GI varices).	Potentially severe.
Hormonal Imbalance	Disrupted estrogen/progesterone balance leads to thickened uterine lining.	Varies (e.g., puberty, menopause, PCOS).	Heavy or irregular menstrual periods.	Varies, can be heavy.

How a Diagnosis is Made

If you have concerns about excessive bleeding, a doctor will follow a clear diagnostic path.

Medical History: Your doctor will ask detailed questions about your bleeding symptoms, menstrual cycle, medication use, and family history of bleeding disorders.
Physical Exam: A physical examination will be conducted to look for signs like excessive bruising or other bleeding manifestations.
Blood Tests: Several blood tests may be ordered to evaluate clotting. These can include a complete blood count (CBC), prothrombin time (PT), partial thromboplastin time (PTT), and specific tests for clotting factors and VWF.
Gynecological Evaluation: If heavy menstrual bleeding is a primary concern, an ultrasound may be used to look for fibroids, polyps, or other uterine issues.

Conclusion

While some level of bleeding is normal, consistently heavier, more prolonged, or unexplained bleeding should not be ignored. It may be an indicator of an underlying issue, from a benign gynecological condition to a more serious inherited bleeding disorder or systemic disease. Taking the initiative to track your symptoms and discuss them with a healthcare provider is essential for an accurate diagnosis and appropriate treatment. Many bleeding issues are treatable and manageable, allowing you to improve your quality of life and prevent complications like anemia. If you experience sudden, severe bleeding, seek emergency medical care immediately.

For more information on bleeding disorders, you can visit the CDC's website.

Frequently Asked Questions

Common signs include frequent or heavy nosebleeds, easy bruising without injury, heavy or prolonged menstrual bleeding, prolonged bleeding from minor cuts, and blood in the urine or stool.

Yes, several medications can increase your bleeding risk. The most common are blood thinners (anticoagulants), nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen, and some antidepressants.

Menorrhagia is the medical term for heavy or prolonged menstrual bleeding. It can be a symptom of underlying conditions such as uterine fibroids, polyps, or hormonal imbalances, or it can be a manifestation of a systemic bleeding disorder like von Willebrand disease.

While easy bruising can be a symptom of a bleeding disorder or other health condition, it is not always serious. However, large, frequent, or unexplained bruises, especially alongside other bleeding symptoms, should be evaluated by a doctor.

Diagnosis typically involves a thorough medical and family history, a physical exam, and blood tests to measure clotting factors, platelet function, and overall blood health. For women, a gynecological exam may also be necessary.

You should see a doctor if your menstrual bleeding lasts more than 7 days, you soak through a pad or tampon every hour for several hours, you pass clots larger than a quarter, or you experience unexplained bruising or bleeding.

Diet can play a supportive role, particularly in addressing iron deficiency anemia caused by heavy bleeding. Ensuring adequate iron and vitamin K intake is important, but dietary changes alone cannot correct an underlying bleeding disorder.

Yes, the liver produces many clotting factors. Severe liver disease, like cirrhosis, can impair this function, leading to easy bruising and a higher risk of serious bleeding.