Managing heavy periods
Written in association with:
Published: 02/12/2024
Edited by: Aoife Maguire
Menstrual periods are a natural part of life for many women, but when they become excessively heavy or prolonged, they can disrupt daily routines, cause physical discomfort, and impact emotional well-being. Known as heavy periods or menorrhagia, this condition affects many individuals, yet it is often under-discussed.
We speak to a leading gynaecological surgeon who advises how to manage heavy periods.
What are heavy periods?
Heavy periods, also known medically as menorrhagia, are a common condition where menstrual bleeding is excessively heavy or prolonged. While every woman’s menstrual flow is different, heavy periods can significantly disrupt daily life and may lead to other health issues. If you find yourself frequently changing pads or tampons, waking up at night to manage bleeding, or experiencing blood clots larger than a 50p coin, you may be dealing with heavy periods.
What causes heavy periods?
There are various reasons why someone might experience heavy menstrual bleeding. Hormonal imbalances, for example, can lead to an overgrowth of the uterine lining, causing heavier shedding during your period. Conditions like fibroids (non-cancerous growths in the uterus), polyps, or endometriosis (when tissue similar to the uterine lining grows outside the uterus) may also contribute to increased flow.
In some cases, heavy periods may be linked to disorders affecting blood clotting, such as von Willebrand disease, or to medications, including blood thinners. Less commonly, conditions such as thyroid disorders or even more serious issues like uterine or cervical cancer could be the underlying cause. If your periods suddenly become very heavy, it’s essential to consult a healthcare professional.
How can you tell if your period is abnormally heavy?
Heavy periods can look different for everyone, but some signs are clear indicators. If your period lasts longer than seven days or you need to change your sanitary product every hour for several consecutive hours, your flow may be heavier than average. Other signs include passing large clots, feeling fatigued, or experiencing symptoms of anaemia, such as dizziness and shortness of breath. Keeping a menstrual diary can help you track these symptoms and provide valuable information to your doctor.
What tests and examinations are used to diagnose heavy periods?
If you suspect your periods are abnormally heavy, your doctor may perform a series of tests to identify the cause. A physical examination may be the first step, often followed by an ultrasound scan to check for abnormalities like fibroids or polyps. Blood tests can help detect anaemia or clotting issues, and sometimes a biopsy (a small sample of uterine tissue) is taken to rule out more serious conditions.
What treatment options are available?
Treatment for heavy periods depends on the underlying cause. Hormonal treatments, such as the combined oral contraceptive pill, can regulate or lighten periods. Another option is a hormonal intrauterine device (IUD), which releases progestin to thin the uterine lining and reduce bleeding.
For non-hormonal solutions, medications like tranexamic acid can help clot blood and reduce flow, while nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can alleviate pain and slightly decrease bleeding.
In more severe cases, surgical options such as endometrial ablation (removal of the uterine lining) or a myomectomy (removal of fibroids) may be recommended.