Heavy periods, called menorrhagia in medical terms, affects one in two women. It could be a sign of an underlying gynaecological condition, so it’s important not to dismiss this as “normal”. So, what should you be looking for?

How heavy is “heavy” bleeding?

Heavy periods are when you experience blood loss which affects your physical, social or emotional quality of life.

In general, your periods are considered heavy if:

• you need to change your tampon or pad every 30 minutes to 2 hours, or empty your menstrual cup more frequently than recommended
• you have to use two products together, such as a pad and a tampon
• you regularly bleed through your clothes or bedsheets (called flooding)
• you have to plan everyday activities, like shopping, going to work or exercise around your periods because you bleed so much

If heavy periods are disrupting your quality of life, make an appointment to see your doctor or GP. If you notice you are bleeding for longer, or your periods are much heavier than usual, this also needs investigating.

What causes heavy periods?

For around 50% of women with heavy periods, no underlying medical cause is found. You might experience heavy bleeding if:

• you’ve just started your periods – they tend to be heavier for the first few years before “settling down”
• you’ve recently had a child or have stopped taking the pill
• you’re perimenopausal (your body is changing in the run up to menopause)
• you have a non-hormonal intrauterine contraceptive device (IUCD), also known as a copper coil, fitted

Some gynaecological conditions can also cause heavy menstrual bleeding, including:

• fibroids
• endometriosis
• adenomyosis
• pelvic inflammatory disease

Very rarely, heavy periods could be a sign of womb or cervical cancer, so it is important to speak to your doctor.

Even if there’s no specific medical cause, you don’t have to put up with heavy periods. There are treatment options available to stop them affecting your life.

​How to stop heavy periods

It’s possible to stop heavy periods. Your first step is to see your GP – find out how to prepare for your appointment here.

Your doctor may want to carry out a vaginal exam, especially if you have other symptoms such as severe period pain, bleeding or pain during or after sex, bloating, and light or ​​heavy bleeding between periods. Your GP may also do a blood test to check if you’re anaemic; losing a lot of blood every month can lead to anaemia. 

They will then work with you to find the best treatment for your heavy periods. For example:

• Do you want to reduce the bleeding or stop it altogether?
• Are you thinking about starting a family?
• What might happen if you don’t have treatment?
• Are there any side-effects to these treatments?
• What about alternatives?

Finding the answers to these questions can help you make the right decision for you. 

Medication for heavy periods

Hormonal treatments

If you don’t want to be pregnant soon and are able to take hormones, then hormonal based treatments/contraceptives are the most effective option.

Your GP can recommend treatments like the combined contraceptive pill, progesterone-only pill or intrauterine system (IUS) - commonly known as the hormonal coil. These can reduce heavy bleeding by up to 95% or even stop your periods completely.

Some GPs and nurses can fit coils for period pains or heavy bleeding but others can only fit coils for contraception. Make sure you say if you’d also benefit from the contraceptive effects. You may have to wait for an appointment at a local service or be referred to the hospital gynaecology clinic.

You don’t need to have periods at all, unless you are currently trying to get pregnant or hormonal treatments aren’t suitable for you. When you’re on the combined contraceptive pill, you don’t need “take a break” to have a period (which isn’t actually a period at all – it's called ‘breakthrough bleeding’) – you can continue taking it to avoid a bleed.

Watch our ambassador Dr Nighat Arif talk about this period tip and more.

Non-hormonal treatments

If you want to get pregnant soon or don’t want to take hormones, your doctor may recommend tranexamic acid, which can reduce menstrual bleeding by around 50%.

You may also be advised to take non-steroidal anti-inflammatory drugs (NSAIDs) <link to: such as ibuprofen. These have been found to reduce heavy bleeding by about 25%. If they don’t work, your doctor may prescribe other NSAIDs such as naproxen or mefenamic acid.

Investigating what causes heavy periods

If your doctor suspects an underlying gynaecological condition that needs further investigation or specialist treatment, they will refer you to a gynaecologist for tests. These could be:

• a hysteroscopy– a narrow telescope with a light and camera on the end, which can see into your vagina and womb
• an ultrasound scan of your lower tummy
• a transvaginal ultrasound – a small ultrasound probe (with a sterile cover), about the width of a finger, goes into the vagina to scan your womb

Any treatment you have will depend on what’s causing your heavy periods. See our separate articles on menstrual health for more information.

Surgery for heavy periods

If a gynaecological condition isn’t the cause, and none of the treatments described above have helped, you may be offered endometrial ablation. This is when the inner lining of your womb is removed by heat, laser or microwaves. After the operation, your periods should be lighter, but your chances of getting pregnant are significantly reduced.

In some cases, the womb lining grows back so you may need another endometrial ablation. The only way to permanently stop period pain and heavy bleeding is a hysterectomy. But this is major surgery and should only be considered when nothing else has stopped your heavy periods.

There are effective treatments available for heavy bleeding, so do speak to your GP or doctor if it’s affecting your life. If you don’t feel like you’re getting the help you need, read this article about what to do if you are feeling dismissed.

Resources

• Shared decision making aid for heavy menstrual bleeding [PDF]

Our “Just a Period” information hub is here to help educate and empower. Get more information and support here.

If you have any symptoms or concerns, always speak to your doctor.