How to manage a heavy period (menstrual menorrhagia)?

Article reviewed by

Dr Rhiannon Bray

Why's my period so heavy? Is having heavy periods normal? How can I tell if my heavy period bleeding is abnormal? What is menorrhagia? These are common questions to ask when you’re experiencing a heavy period flow. Menorrhagia is a disorder that often goes unnoticed by women. Learn about its symptoms and treatment options.

No one likes worrying about whether or not they’re going to leak through their tampon or have to change their tampon every hour, but for many women with heavier periods and heavy menstrual cycles, it’s just what happens during their cycle every month. In rare cases, bleeding too much during your period can be a cause for concern, so it’s best to check with your doctor to rule out any of those. While there’s no such thing as a ‘normal’ period (everyone’s body is different and will have a different menstrual bleeding experience), you can gauge whether your heavier or longer periods are a cause for concern, or if you’re just built to bleed a little more every month.

Table of content:

What is menorrhagia (heavy period)?

Menorrhagia is the official medical name for long or heavy periods. There is also a specific term for heavy or long bleeding between periods: metrorrhagia. Menorrhagia is a disorder in which menstruation occurs with much heavier bleeding than normal. In addition, it usually lasts longer than normal (more than 5 days). Menorrhagia symptoms occurs during normal menstrual days - that is, the menstrual cycle follows the same schedule and does not change puzzlingly. This makes it even more difficult to distinguish and identify the problem.

The main symptom of menorrhagia is very heavy bleeding. A woman who suffers from it has to constantly change her sanitary pads or heavy period tampons during her periods.

What qualifies as heavy menstrual bleeding?

Studies suggest the average person loses around 85 grams of blood per menstrual cycle, which is about two shot glasses worth (six tablespoons), but there’s a wide range since every woman is different. You might be a little taken aback when you bleed through a super absorbency tampon every few hours, but keep in mind that Super tampons for heavy flow are designed to hold 9-12g. If you’re concerned that you’re bleeding through tampons quicker than you think you should, it may be time to see a doctor about your heavy menstrual bleeding.

Having a heavy period flow isn’t necessarily a bad thing if that’s your body’s baseline. It’s very normal to need super plus tampons for heavy flow during your heaviest days, and then switching to regular and light as your period comes to an end. Tampax offers the full range of absorbencies from Light to Super Plus to give you ultimate protection on your heaviest days and smooth removal on your lightest.

Heavy first period

It’s not typical, but it’s perfectly normal to have a heavy first period. So, if you get your first period and it isn’t super light, don’t panic. If you’re worried about a heavy first period, talk to your mum and maybe think about scheduling an appointment to see your doctor to discuss your concerns.

Whenever heavy bleeding occurs during puberty, it is important to visit a gynaecologist who will take a thorough history and order the necessary tests to assess the hormonal profile. It is important to rule out thyroid disease and coagulation disorders

What are the symptoms of menorrhagia (heavy period)?

To find out if you have heavier periods and menorrhagia, ask yourself the following about your period:

  • Does your period last longer than seven days?
  • Is your period so heavy that you have to change your pad or tampon every one to two hours?
  • Do you often also get spotting between periods?
  • Have you always had a heavy period flow or did it start suddenly?

A tendency to heavy periods can, on the one hand, be a physiological, i.e. natural, feature of the female body and, on the other, indicate the presence of various abnormalities or diseases.

Some women simply lose more blood during their period and this does not necessarily indicate anything worrying. However, it is always worth checking, as these could be menorrhagia symptoms. If only to rule out possible ailments and have peace of mind.

If so, you may need to see a doctor to figure out what’s behind your heavy period. Your doctor can help you rule out or investigate any serious potential health concerns or bleeding disorders.

How do you know if you have heavy period?

A normal period flow lasts no more than 7 days (on average 4-6 days) and the average blood loss is 30-80 ml. A loss of more than 80 ml indicates heavy menstrual bleeding. In practice, it is often difficult to know how much 80 ml of blood is. It is therefore worth keeping an eye on the number of pads or tampons used.

One sanitary pad absorbs approximately 5 ml of blood, so it is assumed that the use of more than 20 sanitary pads during a period can be indicative of heavy bleeding. One tampon, on the other hand, absorbs approximately 3 ml of blood. i.e. the use of more than 30 tampons during the entire period may be a sign that you are having a heavy period flow. However, this is still a low-precision measure, as women change pads and tampons frequently for reasons of hygiene and their comfort.

Another way to estimate whether bleeding is excessive is to assess symptoms of anaemia, tiredness, and shortness of breath. Often it is these symptoms which prompt the doctor to ask abut how heavy periods are and then a blood test is suggested. The blood test will measure your haemoglobin (a marker of the oxygen carrying capacity of the blood) before and immediately after the period. If, after the period, the haemoglobin is significantly lower than before it, and even more so if it indicates anaemia, it is possibly due to excessive bleeding.

What causes heavy periods?

Every month, the lining of your uterus sheds during your menstrual cycle. This process relies on hormones like oestrogen and progesterone to be balanced and working in tandem in order to make sure every month flows smoothly. Whether it’s due to a hormonal imbalance, or another underlying condition, some people experience heavier periods each month than others. While this can be annoying, it’s rarely bad enough for you to have to worry about blood loss or anything serious.

Ironically, while hormonal contraceptives may help heavy periods, non-hormonal contraceptive methods like the copper IUD might actually make your periods heavier and your cramps more painful.

In many cases it is difficult to find the exact cause of menorrhagia symptoms. However, some of the most common causes of heavy periods are:

  • Hormonal changes - in many women, hormonal imbalances cause excessive development of the endometrium, the mucous membrane lining the uterus. When this membrane falls away, menstrual bleeding is very intense.
  • Polycystic ovary syndrome - this is one of the factors causing the hormonal imbalance we mentioned.
  • Polyps - small, benign growths of the uterus that cause bleeding to be more intense or prolonged.
  • Copper IUD - this is a method of contraception that is usually called a coil. One of the side effects can be menorrhagia symptoms.
  • Uterine cancer or cervical cancer - this is one of the most serious reasons for heavy periods, but fortunately it is not so common. Cervical cancer It is linked to certain types of the HPV virus the Human papilloma virus (HPV).

Other menorrhagia causes:

  • uterine fibroids,
  • ovarian cysts,
  • endometriosis,
  • thyroid Imbalance,
  • infections including sexually transmitted diseases,
  • blood disorders, including clotting disorders,
  • anatomical defects in the structure of the female reproductive tract,
  • pregnancy loss,
  • Systemic diseases, like liver and kidney disorders, diabetes mellitus, high blood pressure,

Going to see a doctor can rule out uterine fibroids or growths, cancer, bleeding disorders, inflammation, thyroid conditions, or liver or kidney disease. Certain blood-thinning medications may also impact your period and cause a heavier menstrual cycle.

How is heavy period diagnosed?

Diagnosis is usually based on a combination of clinical history, symptoms and the effect on quality of life. Some signs might be :

  • Passing noticeable blood clots,
  • increased weakness and a tendency to get tired quickly – this can be a sign of anemia,
  • prolonged menstruation, even lasting more than 7 days,
  • frequent need to change hygiene products, every 1-2 hours,
  • severe menstrual pain in the lower abdomen and back.

In addition you may notice signs of anaemia:

  • paleness and dryness of the skin and mucous membranes,
  • weakened hair and nails,
  • headaches,
  • problems with concentration,
  • increased heart rate,
  • shortness of breath.

Not all the symptoms listed need to be on the list for you to decide to consult a doctor.

Even if you have doubts, there is nothing stopping you from making an appointment, especially as heavy periods can be a sign of a variety of systemic disorders.

How to manage heavy periods?

There are several ways to help manage heavy periods, depending on the cause. A doctor may recommend hormonal or non-hormonal (conservative) treatments:

  • Hormonal contraception Methods such as the hormonal IUS (coil), the combined pill or the progesterone-only pill can help rebalance hormones, reduce the thickness of the womb lining, and make periods lighter and more regular.
  • Conservative (non-hormonal) treatments These can be helpful if you prefer not to use hormones or while you are waiting for further investigations:
  • Tranexamic acid – taken only during your period, it helps blood to clot and can significantly reduce bleeding.
  • NSAIDs (non-steroidal anti-inflammatory medicines), such as ibuprofen or mefenamic acid – can reduce both period pain and heavy bleeding by lowering prostaglandin levels in the womb.

If heavy periods have caused iron-deficiency anaemia, your doctor may recommend iron supplements or changes to your diet until your iron levels improve. Some people also consider herbal or other supplements, but the scientific evidence for these is limited — so speak to a healthcare professional before trying them.

If tests show that a particular medical condition is causing your heavy periods, your doctor will discuss the most appropriate treatment options for you. In some cases, this might include specialist or surgical treatments, depending on your symptoms and preferences. Don’t hesitate to ask questions — you deserve to understand every option.

How to stop heavy periods? Going on certain forms of hormonal contraceptives may help with your heavy menstrual cycle. They can work by better balancing your hormones. If you are anaemic , your doctor may also recommend iron supplements. If you find you’re bleeding through tampons really quickly, just trying a higher absorbency tampon may also help. Tampax offers Super and Super Plus tampons that may be a better fit for your flow.

What’s the best tampon protection for people with heavy periods?

You might be reassured to know that tampons come in industry standard absorbency ranges, with Super and Super Plus tampons for heavy flow and offering the highest absorbency (9-12g, and 12-15g, respectively). You’re likely already doing this, but go for the most heavy-duty tampon you can find and change it as often as needed for your flow.

How long should a tampon last? If the tampon is placed correctly and changed regularly (every 3-6 hours), it provides reliable protection during menstruation.

You may find that you need to start off with Super Plus absorbency for a few days, and then eventually go down to Super, and then Regular as your period ends. If you use tampons, adding a a menstrual underwear, pad or pantyliner for extra protection will give guarantee your peace of mind.

Check what size tampon you need.

When should I go to the doctor or hospital for heavy bleeding?

When should I see a doctor? See a doctor if:

  • Your periods are so heavy that they affect day-to-day life
  • You regularly need to double up with pads/tampons or change protection every 1–2 hours
  • Bleeding lasts more than 7 days most months
  • You have symptoms of anaemia (such as tiredness, dizziness or shortness of breath)
  • Your periods have suddenly become much heavier
  • You are bleeding between periods or after sex

Getting checked is important to rule out causes that may need treatment — and to help you feel better sooner.