Condition guide
Heavy menstrual bleeding
Periods so heavy they disrupt daily life — soaking through pads or tampons hourly, passing large clots, or lasting more than 7 days.
1 in 3
Women describe their periods as heavy
60%
Develop iron-deficiency anaemia
Treatable
In the vast majority of cases
What it is
Heavy menstrual bleeding (menorrhagia) means losing more than 80ml of blood per cycle or bleeding that interferes with quality of life. It often has an underlying cause such as fibroids, adenomyosis, polyps, hormonal imbalance or a bleeding disorder.
Infographic
What is too heavy?
Tracking pads, clots and days helps your clinician spot menorrhagia.
Common symptoms
- Soaking a pad or tampon every hour for several hours
- Needing double protection (pad + tampon)
- Waking at night to change protection
- Passing clots larger than a 10p coin
- Periods lasting more than 7 days
- Tiredness, breathlessness — signs of anaemia
Causes & risk factors
- Fibroids and polyps
- Adenomyosis or endometriosis
- Hormonal imbalance (PCOS, thyroid, perimenopause)
- Bleeding disorders (e.g. von Willebrand)
- IUDs or certain medications
Diagnosis
- Full blood count and iron studies
- Pelvic ultrasound
- Hysteroscopy if polyps or cavity issues suspected
- Hormone and thyroid testing
Treatment & management
Iron and tranexamic acid
Tranexamic acid taken during the period can cut blood loss by up to 50%.
Hormonal IUD
Often first-line — reduces bleeding dramatically over 3–6 months.
Combined pill or progestins
Regulate cycles and lighten flow.
Endometrial ablation
A short procedure that thins or removes the uterine lining.
Surgery
Myomectomy or hysterectomy when other treatments fail.
When to seek urgent help
Soaking through pads hourly for several hours, dizziness, fainting or palpitations needs emergency care.
Frequently asked
How do I know if my period is too heavy?
If it stops you working, studying or sleeping, or you are tired all the time, it is too heavy.
Will I need a hysterectomy?
Almost never as a first step — many effective non-surgical options exist.
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