About this symptom
Heavy menstrual bleeding describes periods that are so heavy or prolonged that they interfere with everyday activities. You do not need to measure blood loss in millilitres. Frequent changes of sanitary products, fatigue, dizziness and a marked change from your usual cycle are useful signs to report.
Possible causes and features
Possible causes include uterine fibroids, adenomyosis, endometrial polyps, ovulation problems, some medications and bleeding disorders. Symptoms do not confirm any one diagnosis. Heavy bleeding during expected periods is different from unexpected bleeding between periods or after menopause, which needs its own assessment.
Before your appointment record how many days bleeding lasts, whether clots occur, how often products need changing, pain and any other spotting. Note contraceptive use, medicines, possible pregnancy and the effect on work, exercise or routine activities.
Assessment and next steps
A gynecologist assesses the history and may perform an examination. A full blood count is often considered to assess anaemia. Pelvic ultrasound, hysteroscopy or endometrial sampling is chosen according to symptoms and risk factors, not ordered for everybody.
Treatment is not always surgical. Depending on the cause and pregnancy plans it may include nonhormonal or hormonal medicines, monitoring or a targeted intervention for a structural problem. If pregnancy is possible, related complications must be considered before assuming the bleeding is simply a period.
Related topics: Bleeding between periods; Uterine fibroids; Adenomyosis; Hysteroscopy.
Signs and symptoms
- Bleeding that lasts longer or is heavier than usual and limits activities.
- Frequent product changes, clots, tiredness, weakness or dizziness.
- Sometimes painful periods or spotting outside the usual cycle.
Diagnosis and tests
The clinician discusses cycle patterns, other symptoms, medicines and contraception. A full blood count may help identify anaemia. Examination, pelvic ultrasound, hysteroscopy or endometrial tests depend on individual findings; pregnancy testing is considered where relevant.
Care and treatment approaches
Options may include hormonal or nonhormonal treatments for bleeding, management of anaemia and targeted treatment of polyps, submucosal fibroids or other diagnoses. A hysteroscopy is not required for every patient. Do not self-prescribe medication to suppress unexplained bleeding.
When to seek urgent care
Seek emergency care for very heavy bleeding with fainting, marked weakness, breathlessness, chest pain or rapid deterioration. Heavy bleeding or pain when pregnancy is possible also needs urgent assessment. Any bleeding after menopause needs timely investigation; call 103 or 112 for emergencies in Ukraine.
Frequently asked questions
Why have my periods suddenly become heavier?
Possible explanations include hormonal changes, fibroids, adenomyosis or endometrial conditions; the cause is assessed from your history and investigations.
Is hysteroscopy always necessary?
No. It is considered for suspected polyps, submucosal fibroids or endometrial changes, based on the individual situation.
When are heavy periods dangerous?
Severe blood loss with fainting, pronounced weakness, shortness of breath or rapid deterioration requires emergency help.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
