What should you know about excessively heavy period?

Heavy menstrual bleeding may involve soaking protection frequently, passing large clots, bleeding for longer than expected, or finding that bleeding disrupts sleep, work or daily activities. Possible causes include uterine fibroids, adenomyosis, endometrial polyps, endometrial hyperplasia, hormonal changes around perimenopause and polycystic ovary syndrome. Blood loss can reduce iron stores and cause tiredness, dizziness, headaches, breathlessness or paleness. The symptom itself does not identify one cause.

Record when bleeding starts and stops, how often you change protection, clotting, pain and any bleeding between periods or after sex. Arrange a clinician review, particularly if the pattern is new, worsening or affecting your life. Assessment may include a pregnancy test when relevant, blood tests for anaemia and iron, and an examination or scan. Do not take iron or hormonal treatment without advice about the cause and suitable dose.

Seek urgent medical help if bleeding is very heavy and you feel faint, weak, short of breath, confused or unable to stand safely. Get prompt advice for heavy bleeding during pregnancy, severe pelvic pain, fever, or bleeding after menopause. Emergency assessment is also appropriate when bleeding continues despite the measures you were given or you cannot keep up with fluid loss.

Ask which tests are appropriate, whether your blood count and iron should be checked, and whether a scan or sampling of the womb lining is needed. Ask how treatment options affect fertility, contraception and pregnancy plans. Further reading may include [Heavy Periods](/symptoms/heavy-periods/), [Uterine Fibroids](/conditions/uterine-fibroids/) and [Iron Deficiency Anaemia](/conditions/iron-deficiency-anaemia/).