Heavy periods twice a month: what to do

Two episodes may reflect bleeding between periods rather than two complete menstrual cycles. Hormonal changes around perimenopause, polycystic ovary syndrome, or a thickened uterine lining can alter timing. Fibroids, polyps, or adenomyosis may also contribute. Heavy blood loss can lead to iron deficiency anaemia, with tiredness, dizziness, headaches, or breathlessness. A heavy period is a symptom, so its presence does not by itself identify one condition.

Write down the start and end of each episode, the number of products used, clots, pain, bleeding after sex, and any medicines or contraception changes. Take a pregnancy test if pregnancy is possible. A clinician may offer a blood count, iron testing, pregnancy testing, or an examination, and may discuss ultrasound depending on your symptoms. Treatment depends on the cause and your plans for pregnancy.

Seek urgent help if bleeding is rapidly soaking through products, you feel faint or confused, have severe or worsening pelvic pain, or are short of breath at rest. If pregnancy is possible, bleeding with pain, dizziness, or shoulder-tip pain needs urgent assessment. Do not wait for another cycle when the bleeding is substantial or you feel unwell.

Ask what could explain the timing, whether you need blood tests or imaging, how to protect your iron levels, and which treatment is suitable if you want contraception or pregnancy soon.