Menstruation is a natural part of a woman’s reproductive cycle, typically occurring every 21 to 35 days and lasting anywhere from two to seven days. During this time, the body sheds the uterine lining, which results in bleeding. However, the amount of bleeding varies from person to person. Some women experience a light or moderate flow, while others endure heavier periods. But how do you differentiate between a normal menstrual flow and heavy bleeding that requires medical attention? Let’s explore the key differences and when you should seek help.

What Is Considered a Normal Period?

A normal menstrual flow generally follows a predictable pattern in terms of duration, amount, and symptoms. While every woman’s experience is different, a normal period usually:

• Lasts between two and seven days.
• Involves blood loss of about 30-40 ml (around two to three tablespoons) over the course of the cycle.
• Requires changing a pad or tampon every four to six hours.
• May be accompanied by mild to moderate cramping, mood swings, and bloating.

As long as your period remains consistent in terms of flow and duration and does not interfere with your daily activities, it is likely within the normal range.

Signs of Heavy Periods (Menorrhagia)

Heavy menstrual bleeding, medically known as menorrhagia, is more than just an inconvenience—it can significantly impact your daily life and overall health. If you experience any of the following, you may have heavy periods:

• Bleeding that lasts longer than seven days.
• Soaking through a pad or tampon every hour for several consecutive hours.
• Passing large blood clots (bigger than a 10p coin).
• Needing to double up on sanitary protection (e.g., wearing both a pad and tampon).
• Experiencing fatigue, dizziness, or shortness of breath due to blood loss.
• Having to wake up during the night to change protection frequently.

Causes of Heavy Menstrual Bleeding

There are several underlying reasons why some women experience heavy periods. These include:

1. Hormonal Imbalance

An imbalance in oestrogen and progesterone levels can cause the uterine lining to thicken excessively, leading to heavier bleeding when it sheds.

2. Uterine Fibroids or Polyps

These noncancerous growths in the uterus can contribute to excessive menstrual bleeding and prolonged periods.

3. Endometriosis and Adenomyosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, causing severe pain and heavy periods. Adenomyosis happens when this tissue grows into the uterine wall, leading to heavy bleeding.

4. Bleeding Disorders

Certain conditions, such as von Willebrand disease or platelet function disorders, can lead to excessive menstrual bleeding.

5. Pelvic Inflammatory Disease (PID)

Infections affecting the reproductive organs can cause inflammation and heavy bleeding.

6. Use of Intrauterine Devices (IUDs)

Some non-hormonal IUDs, such as the copper coil, may lead to heavier and more painful periods.

7. Pregnancy Complications

Heavy bleeding may also be linked to pregnancy issues such as miscarriage or ectopic pregnancy, which require urgent medical attention.

8. Certain Medications

Blood-thinning medications or anti-inflammatory drugs can contribute to heavier periods.

When to Seek Medical Help

While occasional heavy periods may not always be a cause for concern, persistent or severe bleeding warrants medical evaluation. You should see a doctor if:

• Your periods interfere with daily activities or cause significant discomfort.
• You feel weak, fatigued, or experience symptoms of anaemia (e.g., paleness, dizziness, or shortness of breath).
• You notice irregular cycles or sudden changes in your period pattern.
• You experience bleeding between periods or after menopause.
• You develop severe pain along with heavy bleeding.

Diagnosis and Treatment Options

If you experience heavy menstrual bleeding, a gynaecologist will conduct a thorough assessment, which may include a pelvic exam, blood tests, ultrasound, or other imaging tests to identify the underlying cause.

Treatment options may include:

• Medications: Hormonal birth control, nonsteroidal anti-inflammatory drugs (NSAIDs), or tranexamic acid to manage bleeding.
• Lifestyle Adjustments: Maintaining a healthy diet, reducing stress, and staying active can help regulate periods.
• Procedures: In cases of fibroids, polyps, or severe bleeding, options such as endometrial ablation or surgery may be recommended.

Take Control of Your Health

Heavy periods should not be ignored, especially if they are affecting your quality of life. If you are struggling with excessive bleeding, don’t wait—speak to a professional who can help.

Book an appointment with Dr. Kiranjeet Kaur, Obstetrics & Gynecology, to find the best treatment options for you. Your well-being matters, and getting the right care can help you regain comfort and confidence in your daily life.