Heavy Menstrual Bleeding

*may vary depending on treatment options and procedure.

Understanding heavy menstrual bleeding

Bleeding disorders affect those who menstruate at different points in their lives - for some, it can be during every period cycle.

Also known as menorrhagia, heavy periods can be debilitating and concerning. The NHS confirms that periods are considered abnormally heavy if you:

• Have to change your sanitary pad/tampon or empty your menstrual cup every 1-2 hours

• Have to use double the amount of sanitary products at once

• Have periods that last over 1 week

• Experience blood clots larger than a 10p coin

• Bleed through your underwear to clothes or bedding

• Need to avoid daily activities or take time off work when you’re on your period

• Feel excessively tired or short of breath during your period

Heavy periods can be normal, but they can also be a symptom of an underlying condition. They can also be heavier at different points throughout your life, such as after pregnancy or during menopause.

What causes heavier periods?

• Polycystic ovary syndrome

• Fibroids

• Endometriosis

• Pelvic inflammatory disease

• Medications such as anticoagulant drugs and chemotherapy treatments

• Stress

• Depression.

Abnormal uterine bleeding diagnosis

To understand the cause of your heavy periods, some initial tests and checks might be necessary. You might be asked to give a detailed medical history and keep a diary of your menstrual cycles. After this, a physical exam might be carried out. If necessary, your practitioner might suggest one of the following:

Blood test: To test for iron-deficiency anaemia, thyroid disorders, or blood clotting issues.

Pap smear: To collect cells from your cervix and test them for inflammation or changes.

Endometrial biopsy: Takes a tissue sample from inside of your uterus.

Ultrasound: Used to take images of your uterus, ovaries, and pelvis.
The results of these tests may suggest a need for further testing, which can include:

Colposcopy: Uses a special magnifying instrument to closely examine your cervix, vagina, and vulva.

Hysteroscopy: Examines your uterus more closely using a thin instrument with a light and a camera.

Sonohysterography: A test which involves injecting fluid into your uterus via your vagina and cervix followed by an ultrasound to identify issues in the uterine lining.

Next steps

If you do require further tests, we’ll let you know exactly what these will be and when you can expect to hear your results.

Diagnosing the cause of heavy menstrual bleeding is an important step in treating it. We’ll support you with our range of diagnostic procedures and potential further treatment.