How do I know if my periods are too heavy?
There is no single number that defines a heavy period, because it is hard to measure blood loss at home. What matters is how much it affects you. Signs that your bleeding is heavier than it should be include:
- Changing a pad or tampon every one to two hours, or using two at once
- Periods that last longer than seven days
- Clots larger than a coin
- Waking at night to change protection, or bleeding through clothes or bedding
- Feeling tired, dizzy or short of breath, which can be a sign of anaemia
What causes heavy menstrual bleeding?
Common causes include:
- Fibroids: muscle growths in the womb
- Polyps in the womb lining
- Adenomyosis: womb lining tissue growing into the womb muscle
- Hormonal changes, especially in the teenage years and during perimenopause
- A copper coil, thyroid problems or a bleeding disorder
Less commonly, heavy or irregular bleeding is caused by changes in the womb lining that need treatment. That is why new heavy bleeding over the age of 45 should always be checked.
What tests will I need?
Your doctor will ask about your periods and general health and examine you. A blood test checks for anaemia, and a pelvic ultrasound looks for fibroids, polyps or other changes. Some women also need a hysteroscopy, a thin camera passed into the womb, which can look at the lining and remove polyps at the same time.
How is heavy bleeding treated?
Treatment depends on the cause, your age, and whether you want a pregnancy in the future.
- Non-hormonal medicines taken during your period to reduce bleeding and pain.
- Hormonal options such as a hormonal intrauterine system, the combined pill or progestogen tablets.
- Iron to treat anaemia while the cause is addressed.
- Procedures such as hysteroscopic removal of polyps, fibroid removal (myomectomy) or, when other options have not worked and you do not plan a pregnancy, hysterectomy.
When should I see a doctor?
This article is general information and does not replace a consultation with a doctor. If you are worried about your health, please book a visit or, in an emergency, call +65 6535 8833.
