Heavy periods are common, but they can have a big effect on a woman's everyday life.
They don't always have an underlying cause, but they can result from problems such as fibroids or endometriosis, so it's important to get your symptoms checked out.
See your GP if:
you're worried about your bleeding
your periods have got heavier
you're also having other symptoms, such as period pain or bleeding between your periods
Various treatments are available for heavy periods, including:
some types of contraception, like an intrauterine system (IUS) or the combined pill
medicines, like tranexamic acid
surgery
How much is heavy bleeding?
It's difficult to define exactly what a heavy period is because it varies from woman to woman. Heavy for one woman may be normal for another.
Most women will lose less than 16 teaspoons of blood (80ml) during their period, with the average being around 6 to 8 teaspoons.
Heavy menstrual bleeding is defined as losing 80ml or more in each period, having periods that last longer than 7 days, or both.
However, it's not usually necessary to measure blood loss. Most women have a good idea of how much bleeding is normal for them during their period and can tell when this changes.
A good indication that your periods are heavy is if you:
are having to change your sanitary products every hour or two
are passing blood clots larger than 2.5cm (about the size of a 10p coin)
are bleeding through to your clothes or bedding
need to use two types of sanitary product together – for example, tampons and pads
Heavy periods self-assessment
Take this short test to understand how heavy your periods are and learn more about the treatment options.
Heavy periods aren't necessarily a sign there's anything wrong, but they can affect you physically and emotionally, and cause disruption to your everyday life.
What causes heavy periods?
In about half of women with heavy menstrual bleeding, no underlying reason is found. But there are several conditions and some treatments that can cause heavy menstrual bleeding.
Some conditions of the womb and ovaries can cause heavy bleeding, including:
fibroids – non-cancerous growths that develop in or around the womb and can cause heavy or painful periods
endometriosis – where the tissue that lines the womb (endometrium) is found outside the womb, such as in the ovaries and fallopian tubes (although this is more likely to cause painful periods)
adenomyosis – when tissue from the womb lining becomes embedded in the wall of the womb; this can also cause painful periods
pelvic inflammatory disease (PID) – an infection in the upper genital tract (the womb, fallopian tubes or ovaries) that can cause symptoms like pelvic or abdominal pain, bleeding after sex or between periods, vaginal discharge and fever
endometrial polyps – non-cancerous growths in the lining of the womb or cervix (neck of the womb)
cancer of the womb – the most common symptom is abnormal bleeding, especially after the menopause
polycystic ovary syndrome (PCOS) – a common condition that affects how the ovaries work; it causes irregular periods, and periods can be heavy when they start again
Other conditions that can cause heavy periods include:
blood clotting disorders, such as Von Willebrand disease
an underactive thyroid gland (hypothyroidism) – where the thyroid gland does not produce enough hormones, causing tiredness, weight gain and feelings of depression
diabetes
Medical treatments that can sometimes cause heavy periods include:
an IUD (intrauterine contraceptive device, or "the coil") – this can make your periods heavier for the first 3 to 6 months after insertion
anticoagulant medication – taken to prevent blood clots
some medicines used for chemotherapy
some herbal supplements, which can affect your hormones and may affect your periods – such as ginseng, ginkgo and soya
Seeing a GP and further tests
Your GP will start by asking you about your heavy bleeding, any changes to your periods and any other symptoms you have, like bleeding between your periods or period pain.
All women who have heavy periods should be offered a blood test to check for iron-deficiency anaemia.
The GP may also suggest a physical examination or refer you for further tests to try to find out if there's an underlying cause for your heavy periods. Further tests may include:
other blood tests
an ultrasound scan
a hysteroscopy – where a narrow telescope with a light and camera at the end is passed into the womb through the vagina to examine the inside of the womb
Read more about diagnosing heavy periods.
Treating heavy periods
There are various treatment options for heavy periods. These depend on what's causing your heavy periods, your general health and your preferences.
They include:
an intrauterine system (IUS) – a small device that contains the hormone progestogen is inserted in your womb by a medical professional (often the first treatment offered)
medicines without hormones – such as tranexamic acid or non-steroidal anti-inflammatory drugs (NSAIDS)
medicines with hormones – such as the combined oral contraceptive pill or progestogen tablets
endometrial ablation – a procedure to remove the lining of the womb
myomectomy – surgery to remove fibroids
uterine artery embolisation – a procedure to shrink fibroids
hysterectomy – surgery to remove to the womb
Diagnosis - Heavy periods
See a GP if you feel your periods are unusually heavy or have become heavier. They'll investigate the problem and may offer treatments to help.
Seeing a GP
