Diagnosis - Heavy periods

See your GP if you think your periods are very heavy or have become heavier. They'll ask about the problem and may offer treatments to help.

Seeing your GP

To try to find the cause of your heavy periods, your GP will ask about:

• your medical history, including the contraception you use and the last time you had a cervical screening test
• what your bleeding is like – for example, how long your periods last and how often you need to change sanitary products
• any related symptoms you have, like period pain or bleeding between periods
• what effect your bleeding is having on your everyday life

Your GP may ask if you plan to have a baby.

They'll also ask about your family history to rule out inherited conditions that can cause heavy bleeding. These include Von Willebrand disease, which runs in families and affects blood clotting.

Blood tests

Your GP may give you a full blood test.

This can identify iron deficiency anaemia, which is often caused by heavy periods. If you have iron deficiency anaemia, your GP will likely prescribe iron tablets.

You may need another blood test to check for blood clotting disorders.

Physical examination

Your GP may suggest a physical examination to try to find the cause of your heavy bleeding. You can ask for an examination by a female doctor.

During a physical examination your GP:

• presses on your tummy to feel for any abnormalities
• looks at your cervix using an instrument called a speculum. This holds open the walls inside your vagina
• feels the inside of your vagina to check if your womb or ovaries are tender or enlarged

Before doing a pelvic examination, your doctor will explain the procedure and why it's necessary.

Ask about anything you're unsure about. A pelvic examination should not be done without your consent.

Other tests

Your GP may refer you for other tests if the underlying cause of your heavy periods is unclear.

The tests check for abnormalities in the womb or ovaries, such as fibroids or adenomyosis. They are usually done in a hospital.

Hysteroscopy

This is a procedure to examine the inside of your womb. Your doctor passes a narrow telescope with a light and camera at the end into your womb through your vagina.

Images are sent to a screen, so your doctor or specialist nurse can see inside your womb.

Sometimes they'll do a biopsy at the same time. This involves removing a small sample of your womb lining for examination under a microscope.

Ultrasound scan

Your GP may refer you for an ultrasound scan of your womb. This is an alternative to hysteroscopy.

There are 2 ways to do the ultrasound, from:

• outside your body, called a pelvic ultrasound
• inside your vagina, where your doctor puts a small probe into your vagina to get a close-up image of your womb. This is called a transvaginal ultrasound

The type of ultrasound used will depend on your circumstances.