Are my periods heavy?

There are no set criteria for determining exactly whether your menstrual period is normal as every woman is different. Here's a guide to help you determine when it might be time to chat with your doctor.

Indicators of a heavy period

If you can identify with any of these symptoms your doctor can help you to choose the right treatment option for you. Talking with your doctor will bring you one step closer to gaining relief from heavy periods and regaining control of your life. Remember hysterectomy is not necessarily the answer – it is only recommended if less invasive options are inappropriate or unsuitable.1

  • Your bleeding lasts more than 7 days per cycle
  • Bleeding is so severe that a regular sanitary pad or tampon must be changed every 1-2 hours
  • Your period causes restriction of activities, or even stops you from working
  • You experience severe stomach cramping and loose bowel motions
  • You have missed days at work, or an important family or social event due to heavy bleeding

The Impact of Heavy Periods

The physical effects of heavy menstrual bleeding may include:

  • Periods that last more than 7 days and are bothersome
  • Heavy bleeding that requires doubling up on sanitary protection or changing protection every 1-2 hours
  • Large blood clots
  • Stomach cramps
  • Fatigue or extreme tiredness
  • Anaemia
  • Nausea

Heavy menstrual bleeding is more than just a physical condition; women are often forced to plan their lives around their heavy periods. Research has shown that:

  • More than 60% have had to miss social or athletic events 2
  • About 80% avoid sexual activities 3
  • One-third have been forced to miss work 2

Heavy menstrual bleeding can disrupt the lives of women in other ways as well, and can even lead to:

  • Depression
  • Moodiness
  • Anxiety
  • Reduced confidence or self-esteem

What causes heavy periods?

There are many possible causes of heavy menstrual bleeding, such as a change of hormonal balance, fibroids and polyps, infections or bleeding disorders.

A change of hormonal balance

A change of hormonal balance occurs when the production of oestrogen and progesterone is not balanced. This is a common occurrence among young women and also in the time leading up to menopause. This imbalance can also result from a wrong combination of hormone therapies.

Fibroids and Polyps

Fibroids are mostly benign (non-progressive) tumours in the uterus, while polyps are incidents of endometrial overgrowth. Both can cause heavy menstrual bleeding, and may be removed if they are causing problems.

Infections

Infections of the uterus or cervix can be serious and include excessive blood loss. Infections are generally treated with antibiotics.

Bleeding Deviations

Abnormalities in blood coagulation (thickening of blood for blood loss to slow or stop) are serious disorders and medical treatment is necessary. If you think this is something you suffer from, speak to your doctor as soon as possible.

Heavy periods in menopause

Heavy periods in menopause

Did you know that heavy menstrual bleeding is the most common presentation of abnormal uterine bleeding in pre-menopausal women? 1

Menopause is a time of shifting hormones, which can be very disruptive, but that doesn’t mean you have to live with heavy bleeding at this time of your life.

Talk to your doctor if you are worried about heavy periods whilst going through menopause.

Hysterectomy is not necessarily the answer. The range of management options for heavy menstrual bleeding has improved in the last four decades but recent data shows hysterectomy in Australia remains more common than in many other comparable countries for menstrual disorders, even though less invasive treatment options are available.

Clinical Care Standards for Heavy Menstrual Bleeding are now available – view here.1,4

References

1. Australian Commission on Safety and Quality in Health Care, Clinical Care Standards for Heavy Menstrual Bleeding, October 2017. 2. Cooper J, Gimpelson R, Laberge P, et al. A Randomized, Multicenter Trial of Safety and Efficacy of the NovaSure® System in the Treatment of menorrhagia. J Am Assoc Gynecol Laparosc. 2002;9(4):418-428. 3. National Women’s Health Resource Center. Survey of Women Who Experience Heavy Menstrual Bleeding. Hologic data on file; 2005. 4. Australian Commission on Safety and Quality in Health Care. Available at www.safetyandquality.gov.au/our-work/clinical-care-standards/heavy-menstrual-bleeding/ and www.safetyandquality.gov.au/media_releases/second-atlas-highlights-opportunities-for-healthcare-improvement/. Accessed April 2018. 5.Two Blind Mice. Heavy Menstrual Bleeding Market Research Quantitative survey with 5,000 Australian women. (2023).