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Heavy Periods — Causes, Anaemia Risk and Treatment
Also described as menorrhagia, excessive bleeding, heavy menstrual bleeding.
Periods are heavy if you soak a pad or tampon hourly, pass large clots, bleed beyond seven days, or need double protection. Fibroids, adenomyosis and thyroid disease are common causes, and heavy bleeding frequently causes iron deficiency anaemia that is worth treating in its own right.
🚨 Get emergency care if you have
- •Soaking through protection every hour for several hours — seek urgent care
- •Dizziness, breathlessness or palpitations from blood loss
- •Bleeding between periods or after intercourse
- •Any bleeding after menopause
- •Heavy bleeding with severe pelvic pain
What causes heavy periods?
Uterine fibroids
Benign muscle growths causing heavy, prolonged periods and pressure symptoms.
Adenomyosis
Endometrial tissue within the uterine wall, causing heavy painful periods and a bulky uterus.
Thyroid disorder
Underactive thyroid commonly causes heavy bleeding, and is found on a simple blood test.
Endometrial polyp or hyperplasia
Irregular heavy bleeding, diagnosed on ultrasound and hysteroscopy.
Bleeding disorder
Heavy periods since menarche, sometimes with easy bruising or nosebleeds.
How it is investigated
- ✓Haemoglobin and ferritin — anaemia is common and often missed
- ✓Pelvic ultrasound
- ✓Thyroid function
- ✓Hysteroscopy and endometrial biopsy where indicated
Not every patient needs every test. The consultation decides which of these apply to you.
Frequently asked questions
Do heavy periods always need surgery?▼
No. Medical options — tranexamic acid, hormonal treatment, and the hormonal intrauterine system — control bleeding effectively for most women. Surgery is considered for large fibroids, or when medical treatment fails. Hysterectomy is one option among several, not the default.
Why do I feel exhausted during my periods?▼
Most often iron deficiency from the blood loss itself, which builds gradually and causes fatigue, breathlessness and palpitations. A haemoglobin and ferritin test identifies it, and treating both the iron deficiency and the bleeding resolves the tiredness.
This page is general health information, not a diagnosis or a substitute for a consultation. Symptoms overlap between harmless and serious conditions, and only an examination can tell them apart. If you are worried, see a doctor.
Plan your first visit
Not sure which specialist to see? Tell our care team the reason for your visit and we will help you choose.
- Bring previous prescriptions, relevant test reports or scan images, a medication list and photo ID.
- If you plan to use insurance, bring your policy details. OPD, tests and admission benefits depend on your individual plan and approval.
- Your first consultation determines which tests or treatments are needed; not everyone needs every test listed on this page.
Appointments are requests until confirmed. In a medical emergency, call 044 2025 2025 or go to the nearest emergency department.