Heavy periods

Heavy periods are common, but they can have a big effect on a woman’s everyday life. They do not always have an underlying cause, but they can result from problems such as fibroids or endometriosis, so it’s important to get your symptoms checked out.
See a GP if:
  • you’re worried about your bleeding
  • your periods have got heavier
  • you’re also having other symptoms, such as period pain or bleeding between your periods
Various treatments are available for heavy periods, including:
  • some types of contraception, like an intrauterine system (IUS) or the combined pill
  • medicines, like tranexamic acid
  • surgery

How much is heavy bleeding?

It’s difficult to define exactly what a heavy period is because it varies from woman to woman. Heavy for 1 woman may be normal for another. Most women will lose less than 16 teaspoons of blood (80ml) during their period, with the average being around 6 to 8 teaspoons. Heavy menstrual bleeding is defined as losing 80ml or more in each period, having periods that last longer than 7 days, or both. But it’s not usually necessary to measure blood loss. Most women have a good idea of how much bleeding is normal for them during their period and can tell when this changes. A good indication that your periods are heavy is if you:
  • are having to change your sanitary products every hour or 2
  • are passing blood clots larger than 2.5cm (about the size of a 10p coin)
  • are bleeding through to your clothes or bedding
  • need to use 2 types of sanitary product together (for example, tampons and pads)

What causes heavy periods?

In about half of women with heavy menstrual bleeding, no underlying reason is found. But there are several conditions and some treatments that can cause heavy menstrual bleeding. Some conditions of the womb and ovaries can cause heavy bleeding, including:
  • fibroids – non-cancerous growths that develop in or around the womb and can cause heavy or painful periods
  • endometriosis – where the tissue that lines the womb (endometrium) is found outside the womb, such as in the ovaries and fallopian tubes (although this is more likely to cause painful periods)
  • adenomyosis – when tissue from the womb lining becomes embedded in the wall of the womb; this can also cause painful periods
  • pelvic inflammatory disease (PID) – an infection in the upper genital tract (the womb, fallopian tubes or ovaries) that can cause symptoms like pelvic or abdominal pain, bleeding after sex or between periods, vaginal discharge and a high temperature
  • endometrial polyps – non-cancerous growths in the lining of the womb or cervix (neck of the womb)
  • cancer of the womb – the most common symptom is abnormal bleeding, especially after the menopause
  • polycystic ovary syndrome (PCOS) – a common condition that affects how the ovaries work; it causes irregular periods, and periods can be heavy when they start again
Other conditions that can cause heavy periods include: 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 3 to 6 months after insertion
  • anticoagulant medicine – taken to prevent blood clots
  • some medicines used for chemotherapy
  • some herbal supplements, which can affect your hormones and may affect your periods – such as ginseng, ginkgo and soya

Seeing a GP and further tests

A GP will start by asking you about your heavy bleeding, any changes to your periods and any other symptoms you have, like bleeding between your periods or period pain. All women who have heavy periods should be offered a blood test to check for iron deficiency anaemia. The GP may also suggest a physical examination or refer you for further tests to try to find out if there’s an underlying cause for your heavy periods. Further tests may include:
  • other blood tests
  • an ultrasound scan
  • hysteroscopy – where a narrow telescope with a light and camera at the end is passed into the womb through the vagina to examine the inside of the womb
Find out more about diagnosing heavy periods

Treating heavy periods

There are various treatment options for heavy periods. These depend on what’s causing your heavy periods, your general health and your preferences. They include:
  • an intrauterine system (IUS) – a small device that contains the hormone progestogen is inserted in your womb by a medical professional (often the first treatment offered)
  • medicines without hormones – such as tranexamic acid or non-steroidal anti-inflammatory drugs (NSAIDS)
  • medicines with hormones – such as the combined oral contraceptive pill or progestogen tablets
  • endometrial ablation – a procedure to remove the lining of the womb
  • myomectomy – surgery to remove fibroids
  • uterine artery embolisation – a procedure to shrink fibroids
  • hysterectomy – surgery to remove to the womb
A period is the part of the menstrual cycle when a woman bleeds from her vagina for a few days. For most women this happens every 28 days or so, but it’s common for periods to be more or less frequent than this, ranging from day 21 to day 40 of their menstrual cycle. Your period can last between 3 and 8 days, but it will usually last for about 5 days. The bleeding tends to be heaviest in the first 2 days. When your period is at its heaviest, the blood will be red. On lighter days, it may be pink, brown or black. You’ll lose about 30 to 72ml (5 to 12 teaspoons) of blood during your period, although some women bleed more heavily than this. Read more about heavy periodsperiod painirregular periods and stopped or missed periods.

When do periods start?

Periods usually begin at around the age of 12, although some girls will start them earlier or later. A delay in starting periods isn’t usually a cause for concern. Most girls will be having regular periods by age 16 to 18. Read more about girls and puberty.

Sanitary products

Sanitary products soak up or collect the blood released during your period. The main types of sanitary products are:
  • sanitary pads
  • tampons
  • menstrual cups

Sanitary pads

Sanitary pads are strips of padding that have a sticky side you attach to your underwear to hold them in place. One side of the pad is made of an absorbent material that soaks up the blood. Pads come in many sizes, so you can choose one to suit how heavy or light your period is. Pantyliners are a smaller and thinner type of sanitary pad that can be used on days when your period is very light.

Tampons

Tampons are small tubes of cotton wool that you insert into your vagina to soak up the blood before it comes out of your body. There are 2 types of tampon – ones that come with an applicator and others without an applicator that you insert with your fingers. In both cases, there’s a string at one end of the tampon, which you pull to remove it. Tampons come with instructions that explain how to use them. If the tampon is inserted correctly, you should not be able to feel it inside you. If you can feel it or it hurts, it might not be in properly. It is not possible for a tampon to get stuck or lost inside you. Your vagina holds it firmly in place and it expands inside you as it soaks up the blood. For more information, read:

Menstrual cups

Menstrual cups are an alternative to sanitary pads and tampons. The cup is made from silicone and you put it inside your vagina. Menstrual cups collect the blood rather than absorb it. Unlike sanitary pads and tampons, which are thrown away after they’ve been used, you can wash menstrual cups and and use them again.

PMS (premenstrual syndrome)

Changes in your body’s hormone levels before your period can cause physical and emotional changes. This is known as PMS (premenstrual syndrome) or PMT (premenstrual tension). There are many possible symptoms of PMS, but typical symptoms include:
  • feeling bloated
  • breast tenderness
  • mood swings
  • feeling irritable
  • spotty skin or greasy hair
  • loss of interest in sex
These symptoms usually improve when your period starts and disappear a few days afterwards. Not all women who have periods get PMS.

Getting pregnant

Working out when you can get pregnant – your fertile time – can be difficult. It’s around the time you ovulate, which is about 12 to 14 days before the start of your next period. But sperm can survive inside a woman’s body for up to 7 days before ovulation occurs. This means your fertile time extends back earlier in your cycle. You can calculate when your period will start and your peak ovulation times using an online period calendar. You cannot get pregnant if you do not ovulate. Some hormonal methods of contraception, such as the contraceptive pillcontraceptive patch and contraceptive injection, work by preventing ovulation. Read more about the menstrual cyclefertilitycontraception and getting pregnant.

Changes in your periods

Your periods can change – for example, they may last longer or get lighter. This does not necessarily mean there’s a problem, but it does need to be investigated. You can see your GP, or visit your nearest women’s clinic or contraceptive clinic. Bleeding between periods, bleeding after having sex, or bleeding after the menopause needs to be checked by a doctor. It might be caused by an infection, abnormalities in the neck of the womb (the cervix) or, in rare cases, it could be cancer. You could be pregnant if you miss a period and you’ve had sex. See your GP if you’ve taken a pregnancy test and the result is negative (you’re not pregnant) and you’ve missed 3 consecutive periods. They will investigate the cause and recommend any necessary treatment. Read more about stopped or missed periods.

When do periods stop?

Your periods will continue until you reach the menopause, which usually happens when you are in your late 40s to mid-50s. In the UK the average age of menopause is 51. Your periods may start to become less frequent over a few months or years before stopping altogether. In some cases they can stop suddenly.