Menorrhagia is the medical term for menstrual periods that are unusually heavy or prolonged. On average, around 35ml of blood is lost during a period; however, losing over 80ml of blood per period is considered heavy menstrual bleeding. Although heavy menstrual bleeding is a common concern, most women do not experience severe enough blood loss to be classified as menorrhagia.

Menorrhagia can prevent you from doing normal activities during your period due to excessive blood loss and cramping. You will need to change your tampon or sanitary pad more often, and may continue bleeding for longer than one week. If this is the case, you should consult your doctor about your ongoing heavy bleeding to find the right menorrhagia treatments.

What’s the difference between regular periods and heavy periods?

Everyone’s period is different. While some people may experience only light bleeding, others may have a heavier menstrual flow. On average, periods tend to last around 5 days, with tampons being changed every 4-6 hours and sanitary pads being changed at least once every 4 hours.

In contrast, someone experiencing heavy bleeding periods may find that they last longer and that blood flow is heavier. This means having to change sanitary products more often, as well as experiencing heightened symptoms such as blood clots and severe period pain, which can prevent you from doing your usual daily activities.

Are heavy periods abnormal?

It is possible that heavy menstrual bleeding is normal for you and your periods have always been that way. However, if the amount of blood, pain, or duration of your periods are affecting your everyday life, this is something that should be discussed with your doctor, as there are menorrhagia treatments available to help manage your symptoms.

It’s completely normal to experience slight changes in your period month to month. Blood flow can also increase when you first start your period, after pregnancy, or during menopause.

However, in many cases, there are other underlying causes for heavy periods. That’s why it’s important to discuss your symptoms with your GP, who can help identify the reason for your heavy bleeding and discuss treatment options.

Which conditions cause heavy periods?

Conditions affecting your womb, ovaries, or hormones can be a leading cause of ongoing heavy periods. Diagnosis can often be difficult, but these conditions are commonly considered when identifying the cause of heavy periods:

Polycystic ovary syndrome:

Polycystic ovary syndrome (PCOS) is a hormonal condition which is categorised by 3 main features — irregular periods, high levels of male hormones, and enlarged ovaries that may contain fluid-filled sacs. Occasionally, women with PCOS experience heavier bleeding during their periods as well as irregularities in the menstrual cycle.

Endometriosis:

Endometriosis is a condition in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes, and the tissue lining your pelvis, and it can sometimes be a cause of irregular or heavy periods.

Fibroids:

Fibroids are abnormal growths that form in the muscle of the uterus and occur in up to 80% of women. Large fibroids can push on internal organs and cause pelvic pressure as well as stimulate the growth of blood vessels, which contributes to heavier or irregular periods and spotting between periods.

These conditions usually require a blood test, ultrasound scan, or small surgical procedure to be diagnosed.

In more serious cases, abnormal bleeding may be caused by tumours, growths, or cancer. If heavy periods are unusual for you, this can be discussed with your GP.

Can stress cause heavy periods?

Stress can also affect your periods. Changes to your psychological wellbeing — such as increased stress, anxiety, or depression — may result in heavier vaginal bleeding temporarily. Your physical and mental health are very much interconnected.

Does heavy bleeding cause blood clots?

Passing blood clots during your menstrual cycle is not uncommon. Most women will experience clots, particularly during heavy flow days at the start of their period. However, regular clotting and large clots (those bigger than a 10 pence coin) may be a cause for concern and should get checked out.

Signs of heavy menstrual bleeding (or menorrhagia) may include:

• Bleeding for longer than 1 week.

• Consistently bleeding through your sanitary pads or tampons for several consecutive hours.
• Needing to use double sanitary protection to control your menstrual flow.
• Regularly needing to wake up to change sanitary protection during the night.
• Passing blood clots larger than a 10 pence coin.
• Experiencing excessive menstrual bleeding that restricts daily activities such as work, exercise, and leaving the house.

What physical symptoms does menorrhagia cause?

Common menorrhagia symptoms include:

• Regular period pain such as cramping.
• Blood clots.
• Fatigue, muscle weakness, dizziness, or shortness of breath.

Heavy bleeding can take its toll on your physical and mental health. However, if you are diagnosed with menorrhagia there are many available treatments for heavy periods, including medication and non-medical treatments.

What medication is available for heavy periods?

Several treatments can help you manage heavy periods, such as:

Oral contraceptives: Some oral contraceptive pills can rebalance your hormones, reduce menstrual flow, and prevent prolonged bleeding.

Tranexamic: Tranexamic acid (also known as txa) is a medicine that controls bleeding. It helps your blood clot and is used for nosebleeds and heavy periods.

These options should be discussed with your doctor as they may not be suitable for everyone’s needs.

Painkillers: It’s not uncommon to experience severe cramping during heavy bleeding. Painkillers can be used to ease period pain. Feminax Express uses its anti-inflammatory action to quickly target pain and cramps. Paracetamol and Aspirin can also provide quick pain relief.

There are also non-medical remedies you can do to ease period pain, including:

• Applying heated pads to your lower stomach or using a hot water bottle.
• If possible, working from home during your period or speaking to your employer about flexible work arrangements.
• Having a warm bath to relax your muscles.

When to visit your doctor for heavy menstrual bleeding

Having a heavy menstrual flow can be difficult to manage, and you shouldn’t let your symptoms go untreated for longer than necessary. Speak to your GP to get help diagnosing the cause of your heavy periods and finding the right menorrhagia treatments.

You should visit your doctor if:

• Heavy periods are affecting your life, such as preventing daily activities.
• You've had heavy periods for some time.
• You experience heavy bleeding between periods or after sex.
• You have severe pain during your periods.
• You have heavy periods and other symptoms such as pain when peeing, pooing or having sex.