Your periods count as heavy if they get in the way of your life: work, sleep, exercise or plans. That is how NHS guidance defines it, rather than by a number of pads. Most heavy periods have a treatable cause or none at all, but some need investigating before they are simply managed, and a short conversation with a doctor can tell you which applies to you.
If you are looking for a private doctor in Birmingham to talk about heavy periods, this guide explains what we look for. It is part of our women’s health service.
How do I know if my periods are heavy?
Many women have lived with heavy periods for so long that they no longer notice how much they plan around them. Signs that your bleeding may be heavy include:
- needing to change a pad or tampon every one to two hours
- using two types of protection together, such as a tampon and a pad
- flooding through to clothes or bedding, or getting up at night to change
- passing clots larger than about 2.5 cm
- bleeding for more than seven days
- feeling tired, breathless or washed out, which can point to low iron
What causes heavy periods?
For many women, no underlying cause is found, and the bleeding is still worth treating. When there is a cause, common ones include:
- Fibroids: non-cancerous growths in or around the womb.
- Polyps: small growths in the lining of the womb.
- Adenomyosis: tissue like the womb lining growing into the muscle wall, often with painful periods.
- Endometriosis: usually more linked to pain, but can affect bleeding.
- Hormonal changes: around puberty and in the years before menopause, and with polycystic ovary syndrome.
- Thyroid problems or, less commonly, an inherited bleeding disorder, particularly if periods have been heavy since they started.
- A copper coil or certain medicines, which can make periods heavier.
Rarely, changes in the womb lining, including a thickened lining or womb cancer, can cause abnormal bleeding. The risk is higher after 45, with obesity, or when bleeding happens between periods. This is one of the reasons a proper history matters.
Related readingWhat actually happens at a coil fittingRead the article →When should heavy periods be investigated?
Treatment can often start after a conversation and a blood test. Further investigation is usually worth considering if:
- you bleed between periods or after sex
- your periods have changed noticeably, especially after 40
- you also have pelvic pain or pressure, or need to pass urine more often
- an examination suggests the womb is enlarged
- treatment has not helped
What tests might be done?
- A full blood count to check for anaemia, for everyone with heavy periods.
- Other blood tests, such as thyroid function or clotting, only where your symptoms suggest them.
- An examination, including a look at the cervix and checking your cervical screening is up to date.
- A pelvic ultrasound scan if fibroids or other changes are suspected.
- Referral to a gynaecologist for a hysteroscopy, a camera look inside the womb, where the history or scan suggests it.
The aim is to investigate enough to be safe and confident, not to test for the sake of it.
What treatment options are there?
Once serious causes have been considered, the choice depends on your symptoms, your plans for pregnancy and your preferences. Options include:
- the hormonal coil, which NICE recommends as a first option for many women, and which we explain in what actually happens at a coil fitting
- non-hormonal tablets taken only during your period to reduce blood loss
- other hormone-based medicines we can discuss at your appointment
- iron replacement if you are low
- referral for procedures such as removing fibroids or polyps, where appropriate
When to see a doctor sooner
Speak to a doctor promptly if you have:
- bleeding after sex or between periods
- any bleeding after your periods have stopped for a year or more (after menopause)
- a lump or swelling in your tummy
- symptoms of anaemia, such as breathlessness on mild exertion or a racing heart
Call 999 or go to A&E if you are bleeding so heavily that you are soaking a pad every hour for several hours and feel dizzy, faint or short of breath, or if you could be pregnant and have bleeding with tummy pain. If you are unsure, call NHS 111.
This list is not exhaustive. If you are not sure about something, see a doctor.
How we approach this at Aarva
At Aarva you see a doctor first. We take a full history of your periods and general health, examine you where it is helpful, and arrange the tests that make sense for you. If something needs a specialist, we will say so and help arrange it.
Your plan is agreed with the doctor in the appointment, and any tests are priced before they are taken. We will tell you honestly if a treatment is unlikely to help. Our what to expect page explains the appointment, and you can meet our doctors. If pain is a large part of your story, read painful periods: when to ask more questions, and see our full women’s health service.
Questions patients ask
Are heavy periods normal as I get older?
Periods often change in the years before menopause and can become heavier or less predictable. That is common, but new heavy bleeding, bleeding between periods or bleeding after sex should still be checked by a doctor rather than assumed to be hormonal.
Do I need a scan for heavy periods?
Not always. Many women can start treatment after a history and a blood test. A scan is usually suggested if an examination or your symptoms point to fibroids, polyps or another change in the womb.
Can heavy periods make me anaemic?
Yes. Losing more blood than your body can replace can lower your iron and cause anaemia, which may leave you tired, pale or breathless. A simple blood test can check this.
Will I have to have a coil?
No. The hormonal coil is an effective option for many women, but it is one of several. Your doctor will talk through the choices and the decision is yours.
You do not have to keep planning your life around your periods. The first step is a conversation with a doctor who will listen to the whole picture. Book a consultation, or find your starting point if you are not sure where to begin.
This article is general information and does not replace a consultation with a doctor.
