What are heavy periods?

Heavy menstrual bleeding is excessive blood loss that interferes with your physical, social or emotional quality of life. Losing a lot of blood during your periods can be very distressing.

The amount of blood lost during a period varies from person to person. Some people pass blood clots with their period.

Heavy periods are common and affect about 1 in 4 females.

What symptoms are related to heavy periods?

A period is heavy if you:

• pass blood clots larger than a 50 cent coin
• need to change your tampon or pad every hour
• need to change your tampon or pad overnight
• have to use a towel on your bed or a maternity pad when you sleep
• bleed through clothing
• bleed for more than 8 days

What causes heavy periods?

Finding the cause of heavy periods can be difficult. There are 3 main causes of heavy periods:

1. hormone imbalance
2. changes in your uterus
3. blood disorders

Hormone imbalance may be caused by:

• polycystic ovarian syndrome (PCOS)
• perimenopause — the stage of life leading up to your last period (menopause)
• hypothyroidism (an underactive thyroid)

Heavy periods due to changes in your uterus may be caused by:

• fibroids — lumps in the muscle of your uterus
• polyps — usually non-cancerous growths in the lining of your uterus
• endometrial hyperplasia — when the lining of your uterus becomes too thick
• endometrial cancer
• adenomyosis — when the cells that normally line your uterus grow in the muscle of your uterus
• endometriosis — when the cells that normally line your uterus grow elsewhere in your body

Some people who take blood thinners can also get heavy periods.

For many people with heavy periods, no cause is ever found.

It's normal to have vaginal bleeding (lochia) after giving birth. This bleeding can be quite heavy immediately after birth. The amount of blood will reduce and change to a reddish-brown colour. The bleeding will stop after about 6 weeks.

Bleeding after menopause is never normal. It's important to see your doctor if you bleed after going through menopause.

How is the cause of heavy periods diagnosed?

Your doctor will ask you about your symptoms and general health. They may also examine you and may arrange for tests such as:

• blood tests
• an ultrasound scan

These can help check for any health conditions that may be causing your heavy bleeding.

Your doctor may refer you to a gynaecologist (specialist doctor who manages conditions that affect the female reproductive system) for tests and treatment.

Your doctor should do their best to listen to you and take your concerns seriously. If this doesn't happen, do not be afraid to find a new doctor.

When should I see my doctor?

Speak with your doctor if you are worried about heavy periods or they're affecting your everyday life.

How are heavy periods treated?

Heavy periods can generally be managed with medicines or surgery.

Your doctor will recommend the best option for you. This will depend on:

• your age
• your health
• your medical history
• whether you would like to be pregnant in the future
• how successful other treatments have been

Self-care at home

During your period, you may want to wear a tampon or menstrual cup and a pad or period underwear at the same time. This will give you some extra protection.

Consider putting together a period kit, to keep at school or work. This can include:

• fresh underwear
• tampons, pads, period underwear
• a plastic bag
• a change of clothes

You can care for yourself at home by:

• getting plenty of rest
• keeping a record of your periods
• trying to keep a healthy weight

Medicines and hormones for heavy periods

Medicines and hormones used to treat heavy periods can include:

• Tranexamic acid — which helps your blood to clot.
• Non-steroidal anti-inflammatory drugs (NSAIDS) — to reduce the amount of prostaglandins in the lining of your uterus (which can cause heavy periods).
• A hormone-releasing intrauterine device (IUD) — which stabilises the lining of your uterus.
• The oral contraceptive pill ('the pill') — which stabilises the lining of your uterus.
• The progestogen-only pill — which stabilises the lining of your uterus.

Talk to your doctor about which medicines may be suitable for you.

Other treatment options

Sometimes heavy periods are treated with surgery or other procedures. This can treat the cause of your heavy bleeding.

Procedures can be done to remove:

• the lining of your uterus (an endometrial ablation)
• fibroids in your uterus
• your whole uterus (a hysterectomy)

Complications of heavy periods

Blood loss from heavy periods can lower your levels of iron and red blood cells, causing iron deficiency and anaemia.

Common symptoms of anaemia are:

• tiredness
• dizziness when standing up
• shortness of breath
• palpitations (an awareness of your heart beat)
• pale skin

Resources and support

Learn more about the menstrual cycle on the Jean Hailes for Women's Health website.

Jean Hailes also has a short, animated video about heavy periods. This is available in English, Arabic, Dari, Hindi, Mandarin and Vietnamese.

If you have any concerns about your periods, go to your doctor or local sexual health clinic.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.