Overview - Heavy periods

Heavy periods are common, but they can affect your everyday life.

You may have heavy periods if you:

• have to change your sanitary products every hour or 2
• pass blood clots larger than 2.5cm (about the size of a 50 cent coin)
• bleed through to your clothes or bedding
• need to use 2 types of sanitary product together (for example, tampons and pads)
• have periods lasting more than 7 days

Heavy bleeding

It's difficult to define a heavy period because menstrual bleeding varies. Heavy for 1 woman may be normal for another.

Heavy bleeding is 1 or both of the following:

• bleeding that needs pads and tampons together or extra pads at night
• periods that last longer than 7 days

Causes of heavy periods

For many people with heavy periods, there is no particular cause.

Some conditions of the womb and ovaries that can cause heavy periods are:

• fibroids - non-cancerous growths that develop in or around the womb
• endometriosis
• adenomyosis - when tissue from the lining of your womb grows into the wall of your womb
• endometrial polyps - non-cancerous growths in the lining of the womb or cervix (neck of the womb)
• womb cancer
• polycystic ovary syndrome (PCOS)
• pelvic inflammatory disease (PID) - sexualwellbeing.ie

Other conditions that can cause heavy periods include:

• blood clotting disorders, such as Von Willebrand disease
• hypothyroidism (an underactive thyroid gland)
• diabetes

Medical treatments can sometimes cause heavy periods, for example:

• an IUD (intrauterine contraceptive device or 'the copper coil') - this can make your periods heavier for the first 3 to 6 months after being inserted
• blood-thinning medicines
• some medicines used for chemotherapy
• some herbal supplements, such as ginseng, ginkgo and soya - these can affect your hormones and may affect your periods

Diagnosing heavy periods

Your GP will ask you about:

• your heavy bleeding
• any changes to your periods
• any other symptoms you have - such as bleeding between your periods or period pain

You may need:

• a blood test to check for iron deficiency anaemia
• a physical examination
• an ultrasound scan
• a hysteroscopy - where your doctor checks the inside of your womb

Diagnosing heavy periods

Treating heavy periods

There are many treatment options for heavy periods.

These depend on:

• the cause of your heavy periods
• your general health
• your preferences

Treatment for heavy periods include:

• an intrauterine system (IUS) - this is often the first treatment offered
• medicines without hormones - such as tranexamic acid or non-steroidal anti-inflammatory drugs (NSAIDs)
• medicines with hormones - such as the combined oral contraceptive pill or progestogen tablets
• endometrial ablation - a procedure to remove the lining of the womb
• myomectomy - surgery to remove fibroids
• uterine artery embolisation - a procedure to shrink fibroids
• hysterectomy - surgery to remove the womb

Treating heavy periods