When heavy periods might signal something more serious

Heavy or prolonged periods might be common among some women, nonetheless they are not always “normal” and might signal something else. Any ongoing excessive bleeding can affect health, energy, and daily life. Knowing when to seek medical advice is important. In this article we will explain why and when heavy periods might signal something more.

What counts as a heavy period?

Some women might not know, but a heavy period englobes any of the following:

• Bleeding lasting longer than 7 days
• Soaking through pads or tampons every 1 to 2 hours
• Passing large clots
• Needing double protection or waking at night to change
• Periods interfering with work, sleep, or social life
• Severe pain, dizziness, or large clots (bigger than a 50P coin).

Why heavy bleeding should not be ignored

Any prolonged and/or heavy bleeding can cause symptoms like fatigue, dizziness, breathlessness, extreme tiredness, weakness, and pale skin. These symptoms may mean that your body has lost great amounts of blood, leading to an iron-deficiency anaemia. Besides, the prolonged and heavy bleeding may signal an underlying gynaecological condition that should not be ignored since it might impact fertility and long-term wellbeing.

Conditions doctors often rule out

A. Fibroids

Are non-cancerous growths in the uterus. They are the most common cause of very heavy or prolonged bleeding. Besides bleeding, they may also cause pelvic pressure or bloating.

B. Endometriosis

Is when tissue similar to the womb lining grows in a different place from the uterus. It can cause heavy periods and severe pain, often linked with painful intercourse and fertility issues.

C. Adenomyosis

Is when womb lining tissue, which usually grows in the uterus, starts to grow into the muscle wall. It causes heavy, painful, and longer periods.

D. Hormonal imbalance

Is an incorrect amount of hormones, can be estrogen, progesterone, or testosterone, in the bloodstream, causing irregular ovulation that can thicken the uterine lining, irregular menstrual cycles, and infertility, leading to heavier shedding.

E. Less common but serious causes

There are also other less common but serious causes of heavy bleeding, which are: polyps, bleeding disorders, and more rare, cancer of the womb or cervix.

Are gushing of blood and a more steady flow at other times something bad?

As Doctify-rated Obstetrician & Gynaecologist Dr Neelima Dixit explains, the gush of blood you experience during your period is often due to pooled blood collecting in the vagina when you are sitting or lying down for extended periods. When you stand up or change position, gravity causes this pooled blood to flow out suddenly, creating the sensation of a gush. This phenomenon is common and does not indicate anything abnormal. 

The steady flow at other times occurs when blood is released continuously while you are upright and moving around. Menstrual blood flows from the uterus through the cervix into the vagina at varying rates depending on uterine contractions and hormonal activity. During heavier days of your period (usually days 1-3), uterine contractions are stronger as the body sheds the uterine lining more actively, leading to both heavier flows and occasional gushes.

Factors such as your position, activity level, and uterine contractions influence how blood exits your body. If you find gushes uncomfortable or messy, using products with higher absorbency (e.g., super tampons or menstrual cups) can help manage sudden flows more effectively.

Dr Neelima Dixit, Doctify-rated Obstetrician & Gynaecologist

Signs that mean you should see a doctor sooner

If you experience any of the following, it means you should see a gynaecologist sooner:

• Periods suddenly become much heavier
• Bleeding between periods or after sex
• Pelvic pain worsening each month
• Extreme tiredness or pale skin
• Shortness of breath or fainting

How a gynaecologist investigates heavy periods

Gynaecologists are experts in investigating heavy periods, since they carry out a thorough check-up. They start with a detailed menstrual history, accompanied by blood tests to check for anaemia, and followed by ultrasound to look for fibroids or abnormalities. As well, they utilize swabs or biopsy if needed or considered. Additionally, they use hormone testing when they feel it is appropriate.

Treatment options depend on the cause

Gynaecologists have plenty of treatment options available, but each treatment option depends on the cause. Some examples are: iron supplements for anaemia, hormonal treatments like pill or coil for hormonal imbalance, specific medication to reduce bleeding, minimally invasive procedures for fibroids, and surgery in more severe cases.

Reassurance and next steps

Heavy periods are treatable once the cause is identified. Gynaecologists are experts in investigating heavy periods and early assessment prevents complications like severe anaemia. Booking with a gynaecologist through Doctify can help you get clear answers and the right care sooner.

Feel free to consult a gynaecologist through Doctify for personalised advice whenever you want, we will be happy to help you! Find the best gynaecologyists in the United Kingdom or search for the best specialists globally:

• Gynaecologists in the United Arab Emirates
• Gynaecologists in Germany
• Gynaecologists in Austria
• Gynaecologists in Ireland
• Gynaecologists in Australia

Medically Reviewed
Last reviewed on 20/01/2025