Menorrhagia — How to Manage Heavy Periods
Heavy periods aren’t just annoying. They can make you tired, dizzy, or even lead to iron deficiency. If you regularly soak a pad or tampon every hour for several hours, pass clots bigger than a quarter, or bleed longer than seven days, talk to a clinician. You don’t have to put up with it.
Causes and Tests
There are many reasons for heavy bleeding. Common ones are uterine fibroids, polyps, adenomyosis, hormonal imbalance, and certain contraceptives or blood-thinning medicines. Less common causes include thyroid problems, bleeding disorders, or pregnancy-related issues.
Doctors usually start with a clear history and a pelvic exam. Expect blood tests (complete blood count to check for anemia, and sometimes thyroid tests), a pregnancy test if relevant, and an ultrasound to look at the uterus. If needed, they may suggest hysteroscopy (a camera into the uterus) or endometrial biopsy to check the lining.
Treatment and Practical Tips
Treatment depends on the cause, how severe the bleeding is, and whether you want to get pregnant. Options range from medicines to procedures. Medicines that reduce bleeding include tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs) — these can cut flow and ease cramps. Hormonal options include combined birth control pills, progesterone-only treatments, or a levonorgestrel IUD; these often work well to steady or reduce bleeding.
When medicines aren’t enough, procedures are the next step. Myomectomy removes fibroids. Endometrial ablation reduces the lining so bleeding is lighter. Hysterectomy (removing the uterus) is a permanent option when other treatments fail or aren’t wanted.
While you sort medical care, use practical steps to feel better. Track how much you bleed by counting pads/tampons or using a period app. Eat iron-rich foods (red meat, beans, spinach) and pair them with vitamin C to help absorption. Consider an iron supplement if your doctor finds low hemoglobin. Rest when you need to and keep pain relief handy for cramps.
Know when to seek urgent care: heavy bleeding that soaks a pad every hour for several hours, fainting, very fast heartbeat, chest pain, or trouble breathing. These signs can mean significant blood loss or low oxygen carrying capacity and need prompt attention.
If heavy periods are affecting your life, see a doctor and ask for tests. With the right diagnosis, most people find treatments that meaningfully reduce bleeding and improve energy. Keep notes on your cycle, ask direct questions, and push for answers until you feel confident in the plan.
