Heavy periods: when to see your doctor?

During perimenopause, the balance between oestrogen and progesterone changes. Oestrogen builds up the uterine lining, while progesterone stabilises it. If progesterone levels drop more quickly, the lining can become thicker and shed less evenly. This can result in heavier or more irregular bleeding.

Periods are considered heavy if you need to change your pads or tampons more frequently (within 2 hours), if you lose more than 80 ml of blood during one period, or if your period lasts longer than 7 days. You may also notice frequent leakage or clots in your menstrual blood. Heavy blood loss can make you feel weak, tired, and dizzy.

Read Eloise's story for more insight.

To effectively treat your symptoms, it is important to identify the cause. While hormonal changes during perimenopause are often the reason, other possible causes include:

• Fibroids;
• Uterine polyps;
• Adenomyosis (the uterine lining grows into the muscle wall of the uterus);
• Other medical conditions such as a bleeding disorder or cancer;
• Certain medications.

A doctor can help determine if there is an identifiable cause for the heavy bleeding. Together, you can explore possible treatment options. It is recommended to see your doctor in the following cases:

• You need to change your pads or tampons more than once every 2 hours;
• Your period lasts longer than 7 days or you experience bleeding between periods;
• You experience bleeding (outside of your period) after sex;
• You notice blood clots larger than 2.5 cm or recurring clots;
• You experience bleeding after 12 months without a period;
• You have hair loss, (severe) fatigue, shortness of breath, or bruise easily. These could indicate an iron deficiency or anaemia;
• Your daily life is significantly impacted.

If you are unsure, always make an appointment.

During menopause, heavy bleeding is often caused by hormonal imbalances. You can support your body during this imbalance with diet and lifestyle changes. The following tips may help:

• Reduce stress. After menopause, the adrenal glands partially take over the production of sex hormones. Prolonged stress can cause your adrenal glands to prioritise producing stress hormones over progesterone, leading to a more irregular cycle and heavier periods.
• Eat unprocessed foods and vary your diet as much as possible. This nourishes the bacteria in your gut, which helps break down used hormones and reduces or prevents symptoms.
• Eat iron-rich foods. Heavy blood loss also means losing a lot of iron. Include foods like spinach, legumes, red meat, and whole grains in your diet.
• Look for alternatives to products containing hormone-disrupting substances such as PFAS, BPA, phthalates, and parabens. These are often found in plastic water bottles, cosmetics, non-stick cookware, and cleaning products.

Heavy periods can significantly impact your daily life. It is wise to have your symptoms evaluated. In addition to lifestyle and dietary changes, medical treatments can help. Hormone therapy is often prescribed. If you cannot or do not want to use hormone therapy, there are other options, such as non-hormonal medications or supplements. Get informed about the treatment options that can help you navigate menopause more comfortably.

If lifestyle and dietary changes are not sufficient, medical options can support you and contribute to a more stable and comfortable cycle. Explore the options, request a product, and a doctor will assess whether it is the right solution for your symptoms.

Heavy periods affect many women during menopause. Don’t ignore them, as there are solutions available. It is important to identify the cause so you can effectively address your symptoms, with or without medication. While lifestyle and dietary changes can make a big difference, ensure you see your doctor in time, even if you are unsure.