Menstrual cycle and heavy bleeding

Bleeding may be heavy when you need to change period products very frequently, pass large clots, bleed through clothes or bedding, or cannot manage normal activities. The pattern can be linked to uterine fibroids, adenomyosis, endometrial polyps, endometrial hyperplasia, hormonal changes around perimenopause or polycystic ovary syndrome.

Heavy bleeding itself does not identify one cause. Ongoing blood loss can lead to iron deficiency anaemia, with tiredness, breathlessness, headaches or a racing heartbeat. Pregnancy-related bleeding and medication effects are also considered during an assessment.

Keep a record of start and end dates, product changes, clots, pain, flooding and missed activities. Tell your clinician about pregnancy possibility, medicines, bleeding between periods and bleeding after sex. They may examine you and arrange blood tests or imaging according to your symptoms. Treatment depends on the cause, your health and whether you want pregnancy in the future.

Arrange a clinical appointment when heavy bleeding is new, persistent, worsening or causing fatigue. Seek urgent help if bleeding is soaking through products repeatedly, or if it comes with faintness, severe pelvic pain, chest discomfort, breathlessness or marked weakness. Pregnancy with heavy bleeding or pain needs prompt medical advice.

Ask what pattern of bleeding is concerning, whether you need blood tests for iron deficiency, and which causes fit your symptoms. Discuss treatment choices, effects on fertility, warning signs, and how soon to return if the plan does not improve bleeding.