Heavy periods

Normal period flow varies from woman to woman, so comparing yourself with others does not help much. A better question is whether the bleeding gets in the way of your daily life. If it does, talk to a doctor.

• You need to change a pad or tampon every one to two hours.
• You have to get up at night to change.
• You use two kinds of protection at once.
• You pass large clots, such as the size of a coin or bigger.
• Your period lasts more than 7 days.
• You often leak through your clothes and avoid going out because of it.

Sometimes no clear cause is found. In other cases it can be:

• fibroids or polyps in the womb;
• adenomyosis, when tissue like the womb lining sits in the muscle wall;
• hormonal imbalance, PCOS or thyroid problems;
• blood clotting disorders;
• a copper IUD or certain medicines;
• pregnancy-related problems.

More rarely the cause is a disease of the womb lining, so a lasting change should be checked.

Losing a lot of blood every month can use up your iron stores. This shows up as tiredness, dizziness, pale skin, breathlessness and hair loss. A simple blood test can check. Ask a doctor before starting iron supplements.

Depending on the cause, a doctor may offer medicines, a hormonal IUD or another hormonal method, or in rare cases surgery. Before your visit, note how many days you bleed and how often you change your pad or tampon.