Heavy Periods

What are heavy periods?

Heavy periods (also known as menorrhagia) can occur on their own or in combination with other symptoms, such as period pain (dysmenorrhoea). The amount of blood lost during a period varies from one woman to another, but the average blood loss during a period is two to three tablespoons. Periods are generally regarded as heavy when the blood loss is regularly more than this and they interfere with everyday life.

What are the symptoms of heavy periods?

You might have menorrhagia if you:

  • Have a menstrual flow that soaks through one or more pads or tampons every hour for several hours in a row
  • Need to double up on pads to control your menstrual flow
  • Need to change pads or tampons during the night
  • Have menstrual periods lasting more than 7 days
  • Pass blood clots
  • Have a heavy menstrual flow that keeps you from doing the things you would do normally
  • Have constant pain in the lower part of the stomach during your periods
  • Are tired, lack energy, or are short of breath


What are the causes of heavy periods?

The reason why some women experience heavy periods and others do not is not fully understood. Certain conditions are associated with heavy bleeding, such as;

  • Fibroids or polyps (growths of tissue) in your womb
  • Endometriosis – a condition in which cells that normally line the womb grow outside the womb in other parts of the body
  • Pelvic inflammatory disease – an infection of the reproductive organs, usually caused by a sexually transmitted infection (STI)
  • Polycystic Ovary Syndrome (PCOS) – a condition in which the ovaries aren’t working properly
  • Bleeding disorders
  • An underactive thyroid
  • Medications such as anticoagulants

What investigations are done for heavy periods?

There are a number of investigations for heavy periods, including;

  • Blood tests
  • Cervical smear – cells from your cervix are removed and then looked at to find out if you have an infection, inflammation, or changes in your cells
  • Endometrial biopsy – a sample of tissue is taken from the lining of the uterus to find out if there is any abnormality
  • Ultrasound – your gynaecologist can look at your internal organs and blood vessels
  • Hysteroscopy – a procedure to look at the inside of the uterus using a small telescope and camera to see if you have fibroids, polyps, or other problems that might be causing bleeding

How are heavy periods treated?

There are a number of treatment options available for heavy periods. These may include treatment with medication, insertion of a Mirena coil, an endometrial ablation (a modern minimally invasive surgical technique) or a hysterectomy.

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