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My Body, Periods

Heavy periods

It can be hard to know if you have a heavy period, here we take a look at some of the symptoms of a heavy period, how it might affect you and what treatment options there are.

What are heavy periods?

Here are some common symptoms of heavy periods:

Period bleeding will usually last for 2-7 days with the first couple of days being the heaviest and gradually getting lighter. People with menorrhagia (heavy periods) will often bleed for longer than 7 days or experience a few days of the heaviest flow.

On average, it’s usually about one to five tablespoons’ worth of period blood that leaves the body but for people with heavy periods it can be a lot more. Heavy periods are generally classed as a period of more than 80ml of blood. But this isn’t very helpful as it can be really hard to measure and it can often feel like much more than it is.

It’s easier to think about if you soak through pads/tampons quickly and have to change them every 1-2 hours or if you use pads and tampons at the same time to avoid leaks. If so, it’s likely your periods are heavy.

Blood clots are clumps of blood that can leave the vagina during a period. While they are normal, if they’re over 2.5cm or if you experience them very often it may be a sign of heavy periods and it’s a good idea to see a doctor.

Some people feel a little down during their period but if you’re periods are heavy, the added burden and admin of managing your period can make it worse.

Here are some ways heavy periods may affect you:

  • Worried about leaking onto your clothes when you’re out.
  • Planning your day so you make sure you’re around a toilet where you can change period products.
  • Lower self-esteem and confidence.
  • Avoiding certain activities because of leaks including school or work.

Flooding is when there’s a gush of period blood which may then be hard to absorb quick enough by period products which can lead to leaks. Heavy periods might cause you to leak onto clothes, underwear or bedding regularly.

  • Feeling dizzy, breathless and getting tired easily: This may be a sign of anaemia (low iron) because you’re losing more blood than normal. If you do experience these symptoms, it’s important you see a doctor as a blood test will tell you if you need more iron. If you do, they may suggest iron tablets.
  • Painful periods: Often heavy periods are also painful. If you experience pain that painkillers don’t help with and that are affecting your daily life, it’s important to get help.
  • Affecting sleep: Heavy periods may affect your sleep, whether that’s getting up in the night to change pads or sheets or pain throughout the night.

REAL STORY

“For at least two days each month I have to seriously consider if leaving the house is worth it.”

Read Helen’s story

Important

You may show all these symptoms of heavy periods or just a few. If you’re periods are worrying you or, stopping you from doing normal activities it’s a good idea to see a doctor. There might be nothing wrong or to worry about but it’s best to get peace of mind and to explore your treatment options.

The causes of heavy periods

  • Heavy periods are common as a teenager. This is usually because of “anovulation” which is when your ovaries don’t release an egg each month which is normal in the first few years after your periods start. This can make your periods irregular and your periods heavier and last longer.
  • Approaching menopause. “Anovulation” (when ovaries don’t release an egg) is also more common as you approach the menopause which can lead to irregular periods that can be heavy. It’s best to see a doctor if your periods have become significantly heavier and you think you might be perimenopausal.
  • Bleeding disorders. Some other symptoms of a bleeding disorder are bruising easily, bleeding from cuts and wounds for longer than normal.
  • PCOS (Polycystic ovary syndrome). If your periods are infrequent with PCOS then they may be heavy when they do come. This is because a hormone imbalance can cause the uterus lining to become thicker than normal. It is important that you have at least four periods a year if you have PCOS, please talk to your doctor if you do not.
  • Endometriosis. A condition that causes cells like those found in the lining of the uterus to grow elsewhere in the body. It can also be associated with heavy periods.
  • Adenomyosis. This is a condition where the uterus lining can start to grow into the uterus muscle. It can cause very painful and heavy periods.
  • Fibroids. These are non-cancerous growths in the muscle of the uterus. They are more common if you are aged 30—50 years. Your doctor may suspect these after examining you, but an ultrasound scan would be used to confirm.
  • Polyps. These are small non-cancerous growths in the uterus that can cause your periods to be heavy. They might be seen on an ultrasound scan.
  • Pelvic infection. Please see your doctor if you are worried you may have an STI (sexually transmitted infection), as these can sometimes make your periods heavier and this could be a sign of pelvic inflammatory disease.
  • Some medications. Blood thinners can make your periods heavier.

REAL STORY

“When I was officially diagnosed with PCOS, it was almost a relief. I finally had a name for what I’d been experiencing – a reason for the irregular periods, the heavy bleeding, the constant fatigue.” 

Read Leah’s story

Managing a heavy period

Track your periods

It’s really useful if you track your periods so that you can understand them better and you can bring this information to any healthcare appointments to help with your diagnosis and treatment.

There are lots of period tracking apps you can use, or you can use our period tracker which has been designed by a heavy periods healthcare expert with all the information they need when you go to a consultation with them.

Period tracker

Use heavy flow period products

If fear of leaking is keeping you from going out and doing activities, using different period products may help.

You could try:

  • Doubling up on period products: You could use a tampon/menstrual cup and pad/period pants at the same time. This gives you an extra layer of protection so that if you leak through one product, you’ve still got the pad/period pants to soak up any blood while you find a toilet.
  • Use heavy flow period products: All period products are personalised to different flow levels. Night-time pads can also help as they’re bigger and longer than usual pads.
  • Period pants and menstrual cups: These period products can hold more blood than a typical pad or tampon. They’re also more cost-effective as they’re reusable so although they cost more at the start they last for a long time.
  • Get free period products: Having a heavy period can be expensive. There are places you can get free products including schools, colleges, some universities, some sexual health clinics and foodbanks. You can also ask for “Package for Sandy” at the customer service desk in Morrisons stores to get free products.

Learn more about period products

Nutrition

  • Include lots of iron in your food to help keep your iron levels up. Your GP might recommend iron tablets/liquid iron if they are needed.
  • Maintaining a healthy weight can help your periods become more regular.
  • It might help to avoid certain foods during this time if you find they make your symptoms worse. For example, salty foods can make bloating more uncomfortable.

Get support from those around you

Having heavy periods can be difficult and it might affect your confidence and daily life. But you don’t have to go through it alone.

Talking about it can reduce some of the stigma and by talking to others you might find out that someone you know also experiences heavy periods.

Letting people around you know about what your periods are like and how they affect you can help them be more supportive. It might help them understand if you have to rearrange or cancel plans. You might want them to come to healthcare appointments with you or help you decide about any treatments.

If your work or school work is affected by heavy periods, you could explore ways of making it easier to work or go to school on period days by talking to your teacher, supervisor or manager. Here are a few examples:

  • Working from home during heavy period days.
  • Using a chair if you work in customer service on those days.
  • Moving your desk closer to the toilets.
  • Being allowed to sit out of P.E on period days.

More about your rights at work with heavy periods

If you’re mental health is affected, there are also organisations that can help.

REAL STORY

“I think it’s not often understood how the symptoms of your period and heavy bleeding can affect you in all aspects of your life. “

Read Eden’s story

Menorrhagia treatment options

If you think you have heavy periods and they’re affecting your life, don’t suffer in silence. Your GP will help explore if there’s an underlying cause and can suggest treatment that mean you don’t have to dread this time of the month.  

When you see your GP, they will want to know more about your periods so bring along a tracker for at least the last three periods if you can. The doctor will ask you about periods as well as your general health. They might do a blood test to see if you are anaemic or low of iron. Sometimes, your GP might suggest a vaginal examination to help work out the cause of your heavy bleeding (this us unlikely to be needed if you are a teenager, so please don’t let this put you off seeing a doctor.)

Your GP will explore different options with you and may refer you to a specialist. If you’ve only started your periods in the last few years and they are still quite irregular, they will likely get lighter over time as your menstrual cycle becomes more regular.

Medication  

These are medicines that help with bleeding and can reduce it by 20-60%. They also help with period pain.

Ibuprofen is a NSAID which is most effective for reducing pain if you start taking it 24-48 hours before your period starts (if you’re able to predict when this will be.) It’s really important that you read the label and follow the instructions on how to take NSAIDs. There are some people who this type of medication may not be suitable for.

Another NSAIDs that your doctor may prescribe are called naproxen and mefenamic acid.

Taking these tablets during the heaviest days of your period can reduce the amount of blood you use by 40-60% as they help your blood clot.

These might be prescribed to you by a doctor and are taken during the heaviest days of your period for up to 4 days in a row.

Non-contraceptive hormones

Medroxyprogesterone acetate and Norethisterone are non-contraceptive hormone treatments.

They can be taken as a short course to stop a prolonged bleed or sometimes they can be prescribed to help lighten periods by preventing the uterus lining from becoming too thick. If used in this way they are usually taken for 21 days and then you have a 7 day break in which you bleed. These are usually used for 6-12 months at which point you can come off them to see if your periods have become less heavy and more regular. This is most often used in teenagers looking for a short-term option for managing heavy periods.

These hormones won’t prevent pregnancy so you need to use a contraceptive method when taking these.

Hormonal contraception

Hormonal contraception can help manage your periods including giving you more control over when they start, helping lessen painful periods and making your periods lighter.

With all hormonal contraceptive methods we would advise that it will take at least three months before you’ll start to notice an improvement in your heavy periods. You may experience some side effects which often lessen over time. You must follow the method correctly to maximise their effectiveness at preventing pregnancy.

Progestogen-only contraception methods

Progestogen-only methods contain progestogen but not oestrogen. While you may still get bleeding on these methods, the amount and pattern can be variable and your periods may stop altogether.

  • The progestogen-only pill (“mini-pill”): A pill taken every day and can reduce bleeding by up to 60%.
  • The hormonal coil: Particularly good at making periods lighter and can reduce the amount of bleeding by up to 95% with 10-50% of people saying their periods stopped altogether.
  • Injection: An injection every 8-13 weeks depending on type.
  • Implant: A small rod inserted into upper arm that works for up to three years.

Combined contraception methods

Combined hormonal contraceptives contain oestrogen and progestogen. They can reduce the amount of bleeding by up to 45%.

The combined methods can also help you to plan when to have a bleed as you can choose to take the method back-to-back rather than have week’s break when you would usually have a bleed. This can be helpful to avoid having a bleed at inconvenient times.

  • Combined pill: Pill taken daily.
  • Ring: A flexible plastic ring you insert in the vagina that works for 21 days at a time (at which point you then replace for a new ring or have a week’s break and usually a bleed).
  • Patch: Small beige patch applied to skin like a plaster that works for 7 days at a time (at which point it is replaced with a new path or have a week’s break and usually a bleed.)

Other options

For some conditions, or where other treatments have not worked, your GP may refer to a specialist to consider surgical options.

Learn more

The NHS has developed a Tool to help you work out which treatment option for heavy periods may suit you best.

Learn more about treatment
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