What should you know about abnormally heavy period?

Signs include needing to change menstrual products very frequently, bleeding through clothes or bedding, passing large clots, using two forms of protection together, or avoiding normal activities because of the flow. A clear change from your usual pattern also deserves attention.

Heavy menstrual bleeding can occur when ovulation or hormone patterns change, including during perimenopause or with polycystic ovary syndrome. Changes within the uterus, such as fibroids, adenomyosis, polyps, or thickening of the womb lining, can also present with heavy bleeding. Medicines, a bleeding disorder, pregnancy-related problems, and other health conditions are additional possibilities.

Repeated blood loss can deplete iron and lead to iron deficiency anaemia. Tiredness, dizziness, headaches, paleness, a racing heartbeat, or breathlessness may accompany anaemia and should be mentioned during assessment.

Record when bleeding starts and stops, how often you change products, any flooding or clots, pain, bleeding between periods, and medicines you take. This gives a clinician a clearer picture than labels such as light or heavy alone.

Arrange a routine medical appointment if the pattern is new, recurring, worsening, or affecting sleep, work, exercise, or travel. Assessment may include a pregnancy test when relevant, a blood count and iron checks, examination, or pelvic imaging. Treatment depends on the cause, your other health needs, and whether you want contraception or a future pregnancy.

Seek urgent medical help if bleeding is rapidly soaking through products and is not easing, or if you feel faint, confused, very weak, short of breath, have chest pain, or notice a very fast heartbeat. These can signal substantial blood loss.

Urgent assessment is also appropriate for heavy bleeding with severe pelvic pain, a positive pregnancy test, possible pregnancy, fever, or after menopause. If you may pass out or cannot travel safely, contact emergency services rather than driving yourself.

You could ask: What might explain this change in my bleeding pattern? Do I need a pregnancy test, blood tests for anaemia, or an ultrasound? Which options can reduce bleeding, and how would each affect contraception, fertility, pain, and my existing medicines? What changes should prompt urgent reassessment?