Heavy Periods - What Causes Them and What Can You Do?

Heavy periods are very common, with around around one in three women being affected. In many cases, there is no underlying problem. If you have only just started your periods or if you are close to the menopause, you might also notice that your periods have changed and become heavier.Although heavy bleeding doesn’t necessarily mean there is something wrong, however it’s always important to get changes in your norm investigated, and to seek help if these symptoms are affecting your life negatively. If heavy periods are affecting your everyday life, you should speak to your doctor about ways to manage the bleeding.

During a normal period you should lose on average between 30 and 40 ml (around six to eight teaspoonfuls) of blood per month. While five days is an average duration for a period, some women find that their periods last up to eight days. Usually, most of the blood loss occurs in the first three days.

For a period to be considered heavy you would probably be losing 80 ml or more. The following are signs that your period is heavy:

• when the bleeding comes through your clothes or bedding
• having to get up regularly during the night to change your sanitary towel or tampon
• having to change your sanitary towels or tampons very frequently or use both at the same time
• losing large blood clots

In 40–60% of cases, there is no underlying cause.

Some of the conditions that might cause heavy periods include:

• cervical or endometrial polyps
• endometriosis
• uterine fibroids
• intrauterine contraceptive devices (IUD) (also known as "the contraceptive coil")
• pelvic inflammatory disease (PID)
• polycystic ovary syndrome (PCOS)
• blood clotting disorder
• an underactive thyroid gland (hypothyroidism)

There are also medications and treatments that have been known to cause heavy periods. These include chemotherapy for cancer and anticoagulant medicines that affect the way your blood clots.

There are treatments available for heavy periods, so if it’s affecting your quality of life, ask your doctor for advice. Most of the time, heavy periods can be treated with medication, but in some cases surgery may be required, for example if the heavy bleeding is caused by a physical condition like fibroids or endometriosis.

If there’s no underlying reason and it doesn't affect life, you may feel you do not need treatment.

Medication is usually offered to you if there’s nothing to suggest an underlying problem, or while you’re waiting results of further tests.

The type of medication you’re offered will depend on several different factors, including whether you are trying for a baby or breastfeeding. The types of medication used to treat heavy periods are:

• non steroidal anti inflammatory drugs (NSAIDS)
• tranexamic acid
• contraceptive medication
• synthetic progestogen

If the bleeding is stopping you from having a normal working and/or social life, or has changed from your normal level, then it’s worth speaking to your doctor to see if there’s anything that can be done to help.

Your doctor will ask you questions about your periods to see if you need tests. The type of questions you might be asked include:

• how many days your periods usually last
• how much you are bleeding
• how often you have to change tampon or sanitary towel (or if you wear both)
• if you have any flooding
• whether it’s affecting your everyday activities
• if you have any bleeding between periods or after sex
• If you’re experiencing any pelvic pain
• If you have had any unintentional weight loss or loss of appetite
• If you have a family history of any gynaecological cancers
• If you are a smoker

The traditional IUD (intrauterine device) doesn’t help with heavy periods. In fact, some women who have them fitted find that an IUD causes them to develop heavy bleeding.

Some of the newer hormone-releasing intrauterine systems (IUS) though, can be prescribed to treat heavy periods – the Levonorgestrel intrauterine system is fitted into your womb and releases a hormone called progestogen which stops the lining building up too fast. This type of IUS has been found to reduce blood loss by 71-96 per cent.

The combined contraceptive pill is sometimes used to treat heavy periods and has the benefit of being more easily reversible than the IUS. The pill is also helpful if you have irregular or painful periods as it can help to regulate your cycle.