Heavy periods: When to see a gynaecologist

Heavy periods can be uncomfortable, exhausting and disruptive to everyday life. While menstrual flow naturally varies from person to person, consistently heavy bleeding may indicate an underlying condition worth investigating.

Heavy menstrual bleeding, medically known as menorrhagia, is common, but that doesn’t mean it’s something you should simply put up with.

Understanding what’s normal, recognising changes in your cycle and knowing when to see a gynaecologist can help you take control of your menstrual health.

A heavy period involves excessive menstrual blood loss that affects your physical health, wellbeing or daily activities.

Medically, losing more than 80 mL of blood during menstruation is considered heavy bleeding (O’Flynn & Britten, 2000), although measuring blood loss isn’t always practical.

If you’re regularly changing menstrual products, bleeding for longer than eight days or experiencing significant discomfort, your period may be heavier than normal.

Heavy menstrual bleeding can have several underlying causes, from hormonal changes to conditions affecting the uterus.

Hormonal imbalance

Hormonal changes can affect how the uterine lining develops and sheds, resulting in heavier or prolonged periods. These changes are common during puberty, perimenopause or with conditions such as Polyendocrine metabolic ovarian syndrome (PMOS) – formerly known as PCOS.

Uterine fibroids

Uterine fibroids are non-cancerous growths that develop in or around the uterus. Depending on their size and location, they can cause heavy bleeding, pelvic pressure and discomfort.

Adenomyosis

Adenomyosis occurs when tissue similar to the uterine lining grows into the muscular wall of the uterus, often causing heavy periods, painful cramps and pelvic discomfort.

Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. While commonly associated with pelvic pain, some women also experience heavy or irregular periods. Learn more about endometriosis and its treatment options.

Endometrial polyps

Endometrial polyps are usually benign growths within the uterine lining that can cause heavy periods, irregular bleeding or spotting between periods.

Other possible causes include thyroid conditions, blood clotting disorders and menstrual cycle irregularities. Identifying the underlying cause helps determine the most appropriate treatment.

Recognising the symptoms of excessive menstrual blood loss can help you determine when medical advice may be appropriate.

Common signs include:

• Soaking through pads or tampons every hour for several hours.
• Passing large blood clots in period blood.
• Bleeding for longer than eight days.
• Experiencing fatigue, dizziness or shortness of breath.
• Avoiding everyday activities because of your period.

Persistent heavy bleeding can contribute to iron deficiency anaemia, particularly when blood loss exceeds the body’s ability to replace iron.

You should consider seeing a gynaecologist if heavy bleeding regularly interferes with daily activities, becomes progressively worse or is accompanied by significant pain.

If you’ve found yourself asking, “why is my period so heavy?”, a medical assessment can help identify possible causes rather than simply managing the symptoms.

Seeing an experienced gynaecologist in Melbourne who provides personalised assessment and management of menstrual disorders, including excessive or irregular bleeding can be the most important step when dealing with heavy periods.

If bleeding is severe and accompanied by fainting, marked dizziness or significant weakness, particularly if pregnancy is possible, seek medical attention immediately.

Diagnosing heavy menstrual bleeding begins with understanding your symptoms, medical history and menstrual cycle.

At your initial appointment, Dr Joseph reviews your medical history and discusses your concerns before determining which investigations may be appropriate.

Depending on your circumstances, assessment may involve:

• Medical history: Reviewing bleeding patterns, symptoms, medications and previous conditions.
• Physical examination: Assessing your reproductive health where clinically appropriate.
• Blood tests: Checking for anaemia, iron deficiency or other contributing conditions.
• Pelvic ultrasound: Examining the uterus and ovaries for structural abnormalities.

Further investigations, such as hysteroscopy or endometrial sampling, may be recommended when indicated.

Dr Joseph then reviews all relevant results and discusses an individualised management plan based on your findings and treatment preferences.

Heavy periods shouldn’t prevent you from enjoying everyday life.

Dr Joseph Sgroi provides personalised gynaecological care, taking time to understand your symptoms, concerns and reproductive health goals.

Whether you’re experiencing ongoing heavy bleeding or unexpected changes in your cycle, an individualised assessment can help determine your next steps.

Contact Dr Joseph Sgroi to arrange an appointment and discuss your menstrual health.