Heavy periods

Heavy menstrual bleeding during your period can be really distressing.

It's one of the most common reasons for people who menstruate to see their doctor. According to Women’s Health Concern, 1 in 3 women describe their period as heavy. At least 1 in 20 women speak to their doctor every year about this problem.

For many people, heavy periods have no cause. For others, it's due to a health condition such as fibroids, adenomyosis or endometriosis.

You may be experiencing a heavier than 'normal' period if you’re:

• bleeding through your clothes
• passing large clots
• having to change your period product more frequently
• having to use 2 different products at the same time
• having heavy periods every month that stop you doing everyday activities

When you see your doctor about heavy periods, they will carry out a pelvic examination. They will look at your vulva, vagina and cervix (the opening between the vagina and the womb) to see if there’s anything that could be causing the bleeding.

As this is a very intimate examination, the doctor who performs it will have another person (chaperone) present. You can ask for a female doctor to carry it out. If there isn’t a female doctor available, you can ask if there’s a female health professional who could carry out the examination.

The doctor will also check to see if there are signs of any health conditions which may be causing your symptoms and sometimes other tests might be needed. Your doctor will discuss this with you and you can ask any questions that you might have.

It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an app. You can then discuss this with your doctor who can decide if any tests or treatments might be needed.

If you’re seeing your doctor, there are some useful pieces of information to think about beforehand:

• the first day of your last period (when it started)
• how many days your period usually lasts
• what was the shortest time between your periods (from the first day of one period to the first day of the next)
• what was the longest time between your periods (from the first day of one period to the first day of the next)
• how often you need to change your period products on a heavy day
• if you are over 25, when you had your last smear test

Treatment

Heavy periods don't always need to be treated. But if they’re affecting your daily life, there are different treatments available. These include:

• some types of contraception, such as a hormone-releasing intrauterine system (IUS) or the combined contraceptive pill (‘the pill’)
• medicine to help reduce the amount of menstrual bleeding
• anti-inflammatory painkillers, such as ibuprofen or prescription-only medicines from your doctor

Your doctor might recommend you have a blood test. This can show if you have iron deficiency anaemia, which can be caused by heavy periods.

Underlying health conditions

Heavy periods can be caused by an underlying health condition, including:

• endometriosis – a long-term (chronic) condition where tissue similar to the lining of the womb is found elsewhere in the body
• pelvic inflammatory disease – an infection of the womb, ovaries or/and fallopian tubes
• fibroids – growths that can develop in the muscular wall of womb that are not cancerous
• adenomyosis – when the tissue that normally grows within the womb (the lining) grows into the muscular wall of the womb instead
• polycystic ovary syndrome – a hormonal condition which affects how your ovaries work
• thyroid problems – can also sometimes cause heavy periods

If your doctor thinks that your heavy periods might be caused by an underlying health condition, they may refer you for further scans and tests. This will help to diagnose the condition and decide on the best treatment.

It's ok to ask any questions about your care to help you get the information you might need.