What should you know about heavy bleeding during menses?

Heavy bleeding during menses deserves assessment when it disrupts daily life, causes fatigue, or is heavier or longer than your usual pattern. Heavy menstrual bleeding is also called menorrhagia. It can happen with regular or irregular cycles, and the amount of bleeding can be difficult to judge without tracking your personal pattern.

Heavy periods may be related to changes in the uterine lining, hormone patterns, or the way the uterus contracts. Uterine fibroids, adenomyosis, endometrial polyps, and endometrial hyperplasia can present with heavy bleeding. Perimenopause and polycystic ovary syndrome may also be associated with changing or irregular bleeding. These possibilities do not identify the cause by themselves.

Ongoing blood loss can lower the body's iron stores and lead to iron deficiency anaemia. Tiredness, shortness of breath with activity, dizziness, headaches, or a racing heartbeat can occur when anaemia develops. A clinician may ask about your cycle pattern, pregnancy possibility, medicines, bleeding between periods, and symptoms such as pelvic pressure or pain.

Keep a simple record for each cycle: the start and end dates, the days that feel heaviest, products used, leaks, clots, pain, and any missed activities. Bring the record to an appointment. Mention whether bleeding occurs after sex or between periods, and list medicines or supplements, including blood thinners.

Arrange a medical review if heavy bleeding is recurring, worsening, or affecting work, sleep, exercise, or relationships. Assessment may include a pregnancy test when relevant, blood tests for anaemia, and an examination. Depending on your symptoms, the clinician may discuss imaging or a test of the uterine lining. Do not start iron treatment without advice if the diagnosis is uncertain.

Seek urgent medical help if bleeding is rapidly soaking through protection, you feel faint or confused, you have severe weakness or breathlessness, or you develop severe pelvic pain. Get prompt advice for bleeding during pregnancy, after menopause, or after a procedure. If you are dizzy, sit or lie down while arranging help and avoid driving yourself.

Ask what may be contributing to the bleeding, whether you need a blood count or iron testing, and whether your symptoms call for an ultrasound or another examination. You can also ask which treatment choices fit your health history, how quickly improvement should be expected, and what changes should prompt an earlier review.