A great many women assume their periods are simply difficult and get on with it. Some are right. But several treatable conditions present exactly this way, and a few of them quietly cause anaemia in the background.
These are the causes a gynaecologist works through.
What counts as heavy
Rather than measuring, clinicians ask about impact. Soaking through protection hourly, passing large clots, bleeding for more than seven days, needing to change protection at night, or planning your life around your period all qualify.
Fatigue, breathlessness or looking pale alongside heavy periods suggest iron deficiency, which is common and easily confirmed on a blood count.
Five causes worth excluding
This is not an exhaustive list, but it covers most of what turns up.
- Fibroids — benign growths in the uterine wall, very common and often responsible for heavy bleeding
- Hormonal imbalance, including PCOS and the perimenopausal transition
- Thyroid disease — both underactive and overactive thyroid disturb the cycle
- Endometrial polyps or changes in the uterine lining
- Adenomyosis or endometriosis, particularly where pain is prominent
What the assessment involves
A gynaecology consultation typically starts with your cycle history, an examination and an ultrasound — which is included in the consultation here. Blood tests usually cover a full blood count, ferritin, thyroid function and hormones depending on the picture.
Cervical screening is often done at the same visit if it is due.
What can be done
Treatment follows the cause. Fibroids have several management routes depending on size, location and whether you want to conceive. Hormonal treatments can regulate cycles and reduce bleeding. Iron deficiency is corrected while the underlying cause is addressed.
The point of investigating is not only to stop the bleeding. It is to know what is causing it.
Common questions
When should I see a doctor about heavy periods?
If you are soaking through protection hourly, passing large clots, bleeding longer than seven days, or planning your life around your period, it is worth assessing. Fatigue or breathlessness alongside suggests iron deficiency.
Are irregular periods normal?
Some variation is normal, particularly in the first years after periods start and in the years approaching menopause. Persistently unpredictable cycles outside those windows are worth investigating.
What tests will I need?
Usually a pelvic ultrasound alongside blood tests including a full blood count, ferritin, thyroid function and hormone levels. The ultrasound is included in the consultation at Smart Care.
This article is general health information, not medical advice, and does not replace a consultation. Care at Smart Care Polyclinic is provided by DHA-licensed clinicians.