What should you know about heavy period blood loss?

Repeated heavy menstrual bleeding can gradually reduce iron stores and may cause iron deficiency anaemia. Possible effects include unusual tiredness, weakness, headaches, dizziness, breathlessness with activity, paleness, or a fast heartbeat. These symptoms have other possible causes, so testing is more useful than trying to judge your iron level from symptoms alone.

The underlying bleeding pattern may be linked with uterine fibroids, adenomyosis, endometrial polyps, perimenopause, or polycystic ovary syndrome. Heavy blood loss is a symptom and an effect; it does not identify one condition. Tell a clinician if the change started after childbirth, a procedure, a new medicine, or a change in contraception.

Keep a record of each period, the heaviest days, product changes, clots, flooding, pain, and how symptoms affect activity or sleep. Include vegetarian or restricted diets, previous anaemia, medicines, and pregnancy possibility. A clinician may arrange a blood count and iron testing, then investigate the uterus or hormones when appropriate.

Eat regular iron-containing foods, but do not rely on diet alone if bleeding is heavy or you have symptoms. Iron supplements can be useful for some people and unsuitable for others, so discuss the product and dose with a clinician. Treatment should address both the blood loss and its cause.

Seek urgent help if bleeding is difficult to control or you feel faint, severely dizzy, breathless at rest, confused, extremely weak, or have chest discomfort or severe pelvic pain. Heavy bleeding with a possible pregnancy also needs prompt assessment. Do not wait for a routine blood test when these symptoms are present.

Could I have iron deficiency or anaemia, and which tests should check it? What may be driving the bleeding? How can we reduce blood loss while investigating it? Should I change any medicines or supplements? Which symptoms mean I need urgent care?