Heavy Periods

Heavy periods, or menorrhagia, affects some women. It doesn’t necessarily mean there is anything wrong, however losing an excessive amount of blood during a period can disrupt a woman’s life as well as having physical and emotional impacts.

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There are often reasons why you could be experiencing heavy periods so don’t suffer in silence or feel too embarrassed to talk to a specialist doctor.

  • SEEK HELP – Seek help from a gynaecologist that provides a calm, unhurried environment.
  • DIAGNOSIS – Prompt diagnosis will help undercover what might be causing your symptoms.
  • TREATMENT – Knowing your treatment options allows you to make informed decisions about your women’s health.
  • DON’T DELAY – Prompt treatment of gynaecology conditions often results in a greater chance of success.

Symptoms

There is no definitive definition of a “heavy period” because every woman’s cycle is different. What is a normal amount of blood loss for one woman is heavy for another. On average, women lose 30 to 40 millilitres of blood during a period. Heavy menstrual bleeding is generally considered to be 60 millilitres of blood or more during each period.

A better way of establishing if you are having heavy periods is to consider how they make you feel. Some indicators that you may be losing an excessive amount of blood are:

  • Needing to use towels and tampons together
  • Experiencing flooding (heavy bleeding) through to your clothes or bedding.
  • Using an unusually high number of tampons or towels during your period

Causes

Certain health conditions can cause heavy bleeding, including:

  • Polycystic Ovary Syndrome: this can cause irregular periods. When they start again they can be heavy.
  • Fibroids: non-cancerous growths that develop in or around the womb.
  • Endometriosis: where small pieces of the womb lining are found outside the womb (in the vagina, bladder, fallopian tubes or ovaries)
  • Pelvic Inflammatory Disease: an inflammation in the upper genital tract (womb, fallopian tubes or ovaries) which can cause pelvic or abdominal pain and bleeding between periods or after sex.
  • Cervical or endometrial polyps: non-cancerous growths in the cervix or womb
  • Adenomyosis: a condition where tissue from the womb lining becomes embedded in the wall of the womb.
  • Underactive thyroid gland: where the thyroid gland doesn’t produce enough hormones, leading to depression and weight gain
  • Blood clotting disorders
  • Cancer of the womb

Certain medical treatments can also cause heavy periods, including an IUD (the coil), some anticoagulant medication; some medicines used in chemotherapy

Diagnosis

The first step is normally for your gynaecologist or GP to do a pelvic examination. They may also suggest a blood test to check for anaemia (iron deficiency) and you may also be referred for an ultrasound scan.

Treatment

There is no need for treatment if no serious cause is detected or if the heavy bleeding is not having an adverse effect on your life. If you do need treatment, you will normally be offered medication. It may take a little while to determine the most appropriate medication for you. If this does not solve the problem, you may be referred for surgery.

FAQs

No, this is normal and very common. Heavy bleeding, known as lochia, can occur for between two to six weeks after giving birth. It is your body getting rid of the womb lining. You are likely to experience some bleeding after a caesarean as well, although it may be lighter than if you’d had a vaginal birth. Avoid using tampons. Instead use thick sanitary towels while the flow is at its heaviest, switching to thinner towels as it begins to lessen. The bleeding should settle down naturally after a few weeks. If it doesn’t or if you are worried, talk to your GP or gynaecologist. It is important to visit your doctor if:

  • the bleeding starts to smell unpleasant
  • you develop a fever
  • you are still experiencing heavy, bright red bleeding after the first week (normally it should start to turn more pink in colour)
  • you have pain in your tummy on one or both sides

On rare occasions you may develop a postpartum haemorrhage, which is caused by a piece of placenta remaining inside your womb. If the bleeding is so heavy it is soaking through a thick sanitary pad within an hour, dial 999 as you may need antibiotics or surgery to remove the piece of placenta.

No. Different women experience different levels of flow. What is normal for one woman is heavy for another and vice versa. Unless it is adversely affecting your life, it is nothing to worry about.

Often the first thing that your gynaecologist will suggest is medication. You may be offered something called a levonorgestrel-releasing intrauterine system. This is a small plastic device inserted into your womb which slowly releases progestogen. The aim is to prevent the womb lining from growing too quickly which can lead to heavy periods. It is effective in 90% of cases. If this is ineffective, there are other medications that your gynaecologist can try, or you may require surgery, for example, if the cause of your heavy periods is fibroids.