Heavy Periods

Heavy periods are menstrual periods that last for more than 7 days or involve particularly heavy bleeding. 

The medical term for heavy periods is menorrhagia. Heavy periods are normal for some women, but they can sometimes be a sign of a medical problem that may need treatment. 

Heavy periods may be accompanied by other symptoms like cramps, fatigue, tiredness, and dizziness. They can also cause a condition called iron deficiency anaemia where your body does not have enough iron to be to produce enough red blood cells, which are vital for your body to function properly. 

Symptoms of iron deficiency anaemia include: 

• pale skin
• weakness,  and fatigue
• soreness and inflammation of the mouth and tongue
• brittle nails
• cold hands and feet 

If you experience any of the following, severe symptoms of iron deficiency anaemia, you must seek emergency medical attention:

• chest pain
• fast heartbeat or palpitations
• dizziness
• shortness of breath

A simple blood test can diagnose iron-deficiency anaemia and the condition is normally easily treated with iron supplements. If you think you may have iron deficiency anaemia, make an appointment with a GP. 

If your heavy periods are affecting your quality of life, there are treatments available to help. Seek treatment for heavy periods if you:

• have a period that lasts more than 7 days
• need to change your tampon, pad, or menstrual cup more often than is you would want to
• need to change your pad or tampon during the night
• need  to use more than one sanitary product at a time 
• pass clots larger than a 10 pence coin
• take time off work because of your period
• are unable to carry out some normal activities because of your period
• leak through to your clothes or bedsheets 
• feel excessively tired or short of breath
• you are concerned about your periods
• there has been an unexplained change in your periods

Heavy periods are normal for some women and not necessarily a sign that anything is wrong. Sometimes your period may be temporarily heavy like when you first start your period, after you’ve had a baby, or during menopause. Sometimes heavy periods can be a sign of an underlying health issue or a side effect of some medications, so you should always speak to a doctor if there is a change in your periods.

Medical causes of heavy periods 

Conditions affecting the uterus (womb), or ovaries, including: 

• fibroids —non-cancerous growths that develop in the uterus 
• endometrial polyps —small lumps of tissue that grow in the uterus
• endometrial hyperplasia  —thickening of the lining of the uterus
• endometrial cancer —cancer of the lining of the uterus 
• cervical cancer —cancer of the entrance to the womb (cervix)
• pelvic inflammatory disease (PID) —infection of the female reproductive system including the uterus, ovaries, and fallopian tubes.
• adenomyosis —when the endometrial glands grow into the wall of the uterus.
• polycystic ovarian syndrome (PCOS) — a hormonal imbalance that causes the ovaries to become enlarged and filled with fluid-filled sacs. 

Medications or treatments, including: 

• blood thinners (anticoagulants) 
• cancer treatments such as chemotherapy 
• some types of birth control such as the intrauterine device (IUD) 

Medical conditions, including:

• clotting or bleeding disorders 
• liver, kidney, or thyroid disease 
• depression
• stress 

Following an assessment by a doctor, to rule out anything worrying, you may decide with your doctor that treatment for heavy periods isn’t needed, especially ifyour periods aren’t impacting your quality of life. Taking care of your general health, eating a balanced diet, and taking regular exercise can help improve your periods as well as your overall well-being. 

If you decide on treatment, the right treatment for you will depend on the cause. Treatments for heavy periods include:

• medications
• hormonal treatments
• surgery 

 

Medications for heavy periods include: 

• tranexamic acid and aminocaproic acid prevent clots from breaking down once they have formed.
• desmopressin nasal spray (Stimate) promotes clotting in people with bleeding disorders like von Willebrand disease and mild types of haemophilia.
• ibuprofen or other non-steroidal anti-inflammatory drugs like mefenamic acid or naproxen can help with cramps and may reduce bleeding.

Hormonal treatments may help to regulate periods and reduce bleeding. 

Hormonal treatments for heavy periods include: 

• the combined contraceptive pill contains the female hormones oestrogen and progestogen. 
• intrauterine devices (IUDs) such as the Levonorgestrel-releasing intrauterine system (LNG-IUS/Mirena) are inserted into the uterus and release progestogen slowly.
• long-acting progestogen contraceptives are available as an injection given every 12 weeks or as an implant under the skin.
• oral progestogens like norethisterone are not usually given for heavy periods, but they may be used as an emergency treatment to quickly stop very heavy bleeding, or delay periods for events like holidays and weddings.

Surgical treatments are a last resort for heavy periods and are usually only considered when other treatment options haven’t worked. Some surgeries include removal of the womb or womb lining which means you will be unable to have children after the procedure. 

Surgical options include: 

• operative hysteroscopy. This is a procedure where a surgical tool examines the inside of the uterus for abnormalities. It can also be used to remove any fibroids or polyps, correct abnormalities, and remove the lining of the uterus. 
• dilation andcCurettage (D&C) removes the top layer of the lining of the uterus.
• endometrial ablation or resection are 2 types of surgical procedures where all or part of the lining of the uterus is removed. You will not be able to have children after this procedure. 
• hysterectomy involves surgical removal of the uterus. After a hysterectomy, you will stop having periods and will no longer be able to have children.

If you have heavy periods and would like to talk about treatment options, make an appointment with one of our NHS-trained doctors today. 

Making an appointment with Medicspot is quick and easy online. Simply choose a time that is convenient for you, and have your appointment by video link from your phone wherever you are. 

NHS: Heavy periods November 3rd 2021 (Accessed August 24th 2022) 

Centers for Disease Control and Prevention: Heavy Menstrual Bleeding  August 17th 2022 (Accessed August 24th 2022)

NIH: What are the treatment options for heavy periods? May 4th 2017 (Accessed August 24th 2022)

PubMed: Medical management of heavy menstrual bleeding January 2016 (Accessed August 24th 2022)

Patient: Heavy periods. Menorrhagia  August 24th 2020 (Accessed August 24th 2022)