Heavy and prolonged menstrual bleeding: what to know

A period may be unusually heavy when you need to change protection very often, pass large clots, bleed through clothing or bedding, or cannot manage normal activities. Bleeding that continues longer than your usual pattern also matters. Possible contributors include fibroids, adenomyosis, polyps, changes around perimenopause, polycystic ovary syndrome, or a thickened womb lining. The symptom itself does not identify one condition.

Ongoing blood loss can use up iron stores. Tiredness, reduced exercise tolerance, headaches, dizziness or breathlessness can occur with iron deficiency anaemia and should be mentioned during assessment.

Arrange a medical appointment if this pattern is new, recurring or interfering with work, sleep, sex or exercise. Keep a brief record of bleeding days, how often protection is changed, clots, pain, medicines and any chance of pregnancy. A clinician may ask about your cycle, examine you and consider blood tests or imaging. Treatment depends on the cause, your health, pregnancy plans and preferences.

Seek urgent medical help if bleeding is rapidly soaking protection, you feel faint or unusually weak, have severe pelvic pain, shortness of breath, chest discomfort, or could be pregnant. Do not drive yourself if you feel about to faint. A sudden change with marked dizziness needs prompt attention even if the bleeding later slows.

Ask what might explain the change, whether you need a blood count or iron check, which treatments fit your pregnancy plans, and what amount of bleeding should trigger urgent help.