Menorrhagia, heavy menstruation,

Some women lose an excessive amount of blood during their period.

The medical term for heavy periods is 'menorrhagia'. It can sometimes happen along with other symptoms too, such as painful periods.

Heavy bleeding doesn't necessarily mean there's anything seriously wrong, but it can affect a woman physically and emotionally, and disrupt everyday life.

See your GP if you're worried about heavy bleeding during or between your periods.


How much is heavy bleeding?

It's difficult to define exactly what a heavy period is because this varies from woman to woman. What's heavy for one woman may be normal for another.

The average amount of blood lost during a period is 30-40 millilitres (ml), with 9 out of 10 women losing less than 80 ml. Heavy menstrual bleeding is considered to be 60 ml or more in each cycle.

However, it's not usually necessary to measure blood loss. Most women have a good idea about how much bleeding is normal for them during their period and can tell when this amount increases or decreases.

A good indication that your blood loss is excessive is if:

  • you feel you're using an unusually high number of tampons or pads
  • you experience flooding (heavy bleeding) through to your clothes or bedding
  • you need to use tampons and towels together

What causes heavy periods?

In some cases, the cause of heavy periods can't be identified. However, there are a number of conditions and some treatments that can cause heavy menstrual bleeding.

Conditions that can cause heavy bleeding include:

  • polycystic ovary syndrome (PCOS) a common condition that affects how the ovaries work; it causes irregular periods and when periods return they can be heavy
  • pelvic inflammatory disease (PID) an infection in the upper genital tract (the womb, fallopian tubes or ovaries) that can cause pelvic or abdominal pain and bleeding after sex or between periods
  • fibroids non-cancerous growths that develop in or around the womb and can cause heavy or painful periods
  • adenomyosis when tissue from the womb lining becomes embedded in the wall of the womb
  • endometriosis when small pieces of the womb lining are found outside the womb, such as in the fallopian tubes, ovaries, bladder or vagina (although this is more likely to cause painful periods)
  • an underactive thyroidgland (hypothyroidism) where the thyroid gland doesn't produce enough hormones, causing tiredness, weight gain and feelings of depression
  • cervical or endometrial polyps non-cancerous growths in the lining of the womb or cervix (neck of the womb)
  • blood clotting disorders, such as Von Willebrand disease
  • cancer of the womb (although this is relatively rare)

Medical treatments that can sometimes cause heavy periods include:

  • an IUD (intrauterine contraceptive device, or 'the coil') this can make your periods heavier for the first three to six months after insertion
  • anticoagulant medication (taken to prevent blood clots )
  • some medicines used for chemotherapy

Diagnosing heavy periods

Your GP will usually investigate heavy periods by carrying outa pelvic examination . A blood test may also sometimes be recommended to check for anaemia (iron deficiency).

If an underlying cause of your heavy periods isn't found, you may have an ultrasound scan.

However, it may take a while to find a medication that is effective and suitable for you. Some treatments also act as contraception .

If medication doesn't work, surgery may be a possible treatment option.

It's your body's way of getting rid of the womb lining after you've given birth.

The bleeding can last from two to six weeks, and the blood may come out quickly or slowly and evenly. The amount of blood loss varies between women. If you've had a caesarean section, you'll also have some bleeding as the womb lining sheds, although it may be lighter than if you've had a vaginal birth.

You'll need to use thick sanitary pads to start with while the bleeding is at its heaviest. Once the flow settles down, you can switch to using normal sanitary pads. Always wash your hands before and after changing your pad. Don't use tampons for the first six weeks after the birth because it increases the risk of your womb becoming infected.

The colour of the blood will also change in the days and weeks after childbirth. It will be bright red for the first few days and may contain small clots. As the bleeding becomes less heavy, the colour of the blood will lighten, becoming pinkish and more watery.

It's important to make sure you get plenty of rest and don't overdo it during this time.

You should seek medical advice from your GP or midwife if:

  • the bleeding smells unpleasant
  • you get a fever and/or chills
  • you still have heavy, bright red bleeding after the first week
  • you have lower tummy pain on one or both sides

Dial the emergency number to ask for an ambulance if you experience very heavy bleeding after having a baby (bleeding that soaks through more than one pad an hour).

It could be a postpartum haemorrhage caused by a piece of placenta still inside your womb. You may need antibiotics or an operation to remove the piece of placenta.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 4 Oct 2016