Heavy periods and fibroids: what to know

Fibroids are non-cancerous growths in the muscular wall or around the womb. Their size and position matter: a growth close to the inner cavity can interfere with the lining and cause heavier or longer bleeding, while another position may cause pressure or pelvic discomfort instead. A heavy period may also have other explanations, including adenomyosis, endometrial polyps, hormonal changes around perimenopause, or a bleeding disorder. Heavy blood loss can lead to iron deficiency anaemia, with tiredness, breathlessness on exertion, headaches, or reduced concentration.

A clinician may ask about bleeding days, clots, pain, pressure, pregnancy possibility, medicines, and changes over time. Assessment can include an examination, blood tests, and an ultrasound; the choice depends on your symptoms and history.

Record when bleeding starts and stops, how often you change period products, clots, pain, dizziness, and whether bleeding occurs between periods or after sex. Arrange a medical appointment if the pattern is new, worsening, disrupts sleep or school or work, or leaves you unusually tired. Do not start iron supplements or hormone treatment without advice, because the right option depends on your blood results, pregnancy plans, fibroid location, and other conditions. A clinician can discuss medicines that reduce bleeding, treatment for anaemia, or procedures when appropriate.

Seek urgent medical care if bleeding is very heavy and you feel faint, weak, short of breath, confused, or have chest discomfort. Get prompt assessment for severe or rapidly increasing pelvic pain, fever with pelvic symptoms, bleeding during pregnancy, or bleeding after menopause. These warning signs need attention regardless of whether fibroids have been diagnosed.

Ask whether your symptoms fit fibroids or another cause, whether you need a blood count and iron testing, where any fibroids are located, and which treatments fit your bleeding pattern and plans for pregnancy. Ask what changes should prompt urgent care and when your response should be reviewed.