What should you know about random heavy period?

A heavy bleed can happen when ovulation is irregular, including during perimenopause or with polycystic ovary syndrome. Adenomyosis and uterine fibroids can alter the uterine muscle and increase bleeding. Endometrial polyps may bleed unpredictably. Endometrial hyperplasia is another possible explanation. Heavy blood loss over time can contribute to iron deficiency anaemia, which may cause tiredness, breathlessness or paleness.

A clinician may ask about your usual pattern, pregnancy possibility, medicines, bleeding between periods and pain. Tests can include a pregnancy test, blood count, iron assessment, pelvic examination or ultrasound, depending on your history.

Track when the bleeding began, how often you need to change menstrual products, whether clots occur, and whether you feel dizzy or short of breath. Arrange a review if this is a new pattern, keeps returning, affects daily activities, or leaves you exhausted. The [Heavy Periods](/symptoms/heavy-periods/) guide can help you describe the pattern. Ask whether you need assessment for [Iron Deficiency Anaemia](/conditions/iron-deficiency-anaemia/).

Seek urgent care if bleeding is rapidly soaking through products, you feel faint or very weak, have severe pelvic pain, chest discomfort, breathlessness, or possible pregnancy with pain or bleeding. Prompt assessment is also needed for bleeding after menopause. Do not drive yourself if you feel faint.

Could fibroids, adenomyosis, polyps or a hormone change explain this? Do I need a blood count or iron test? Could my medicine affect bleeding? What treatment options fit my health and pregnancy plans?