Many women have heavy periods (also called menorrhagia) and they may be normal for you. They can affect anyone who has periods. Treatment can help if they're affecting your daily life.

What are heavy periods?

You may have heavy periods if you:

• need to change your pad or tampon every 1 to 2 hours, or empty your menstrual cup more often than is recommended
• need to use 2 types of period product together, such as a pad and a tampon
• have periods lasting more than 7 days
• pass blood clots larger than about 2.5cm (the size of a 10p coin)
• bleed through to your clothes or bedding
• avoid daily activities, like exercise, or take time off work because of your periods
• feel tired or short of breath a lot

Causes of heavy periods

It can be normal to have heavy periods. They can sometimes be heavy at different times, like when you first start your periods, after pregnancy or during menopause. Sometimes, they can be caused by:

• conditions affecting your womb, ovaries or hormones, such as polycystic ovary syndrome, fibroids, endometriosis, adenomyosis and pelvic inflammatory disease
• some medicines and treatments, including some anticoagulant medicines and chemotherapy medicines
• stress and depression

Rarely, heavy periods can be a sign of womb cancer.

Treatment for heavy periods

Heavy periods do not always need to be treated. But there are treatments that can help if they’re affecting your daily life. Treatments from a GP include:

• some types of contraception, such as an intrauterine system (IUS) or the combined contraceptive pill
• medicine to help reduce the bleeding, such as tranexamic acid
• prescription-only anti-inflammatory painkillers, such as mefenamic acid or naproxen

You should have a blood test to check if you have iron deficiency anaemia. If these treatments do not work or a GP thinks a condition may be causing your heavy periods, they’ll usually refer you for tests or to see a specialist.

Specialist treatments

Specialist treatments for heavy periods include:

• removing the lining of the womb (endometrial ablation)
• removing fibroids if it’s thought they’re causing your heavy periods
• total or partial removal of the womb (hysterectomy)

You may have a series of blood tests to check if you have any underlying conditions, such as iron deficiency anaemia.