A super-absorbent tampon, nightpad and menstrual panties combo and your period still leaks through. Sounds like a case of unusually heavy periods. And you’re not alone. In fact, up to 33% of women describe their periods as heavy and more than 20% of women seek medical help for heavy periods.

What causes heavy periods and what can be done about them? But first: where does menstrual bleeding come from and what does it consist of?

Menstrual bleeding

Menstrual blood is a mixture of vaginal discharge, blood, uterine bacterial flora and the lining of the uterus. When a detached egg fails to fertilise and attach to the thickened lining of the uterine wall, menstruation begins. The lining of the uterus breaks down and flows out through the vagina.

What is a normal amount of menstrual bleeding?

Usually, the amount we bleed during a period is about 2-8 tablespoons, with an average of about 80 ml, ie two shot glasses. OK – but how can you judge this for yourself? We’ve given some examples of heavier-than-normal flow below:

• Insufficient absorbency of a tampon, pad or other menstrual product such as period panties or a menstrual cup, resulting in blood-stained clothing
• The need to use more than one menstrual product at the same time
• Large clots (the size of a strawberry or bigger) in the menstrual flow
• Need to change your menstrual product every 1-2 hours
• Flow lasting more than 7 days
• Restriction of normal hobbies and activities due to menstruation

What causes heavy periods?

Sometimes there is no specific reason or explanation for heavy periods. Sometimes, however, heavy periods are caused by a medical condition such as myomas, adenomyosis, inflammation, PCOS (polycystic ovary syndrome) or endometriosis.

Approaching menopause can also lead to increased menstrual bleeding.

When to raise the issue with your doctor?

If one or more examples listed above apply to your usual period, it may be a good idea to contact your doctor and discuss the issue. Or if your periods suddenly become heavier than usual, it’s worth having a checkup with your healthcare provider.

The following information, among other things, will help your doctor’s investigation and diagnosis:

• The date of your last period
• How long your periods usually last
• Are your periods regular or do they vary in length? What is the longest and shortest period you have had?
• How often do you have to change your menstrual product on the day of your heaviest flow?
• If you are over 25 years old, when was your last pap smear?

Your doctor may also order blood tests to check for low haemoglobin and iron levels. Low haemoglobin, or anaemia, can naturally result from heavy periods.

Many different menstrual tracking apps make it easy for you to keep track of everything listed above and stay better informed about your menstrual cycle.

What can help with heavy periods?

If heavy periods don’t significantly interfere with your well-being and life, you don’t necessarily need to do anything about them. However, quality of life can easily be improved in many cases through a variety of treatments. These include:

• Many contraceptive methods, such as hormonal IUD, combined contraceptive pill or the progesterone-only-pill
• Anti-bleeding medication to reduce the flow (tranexamic acid)
• Progesterone pill in a shorter period, which not only regularises but usually also reduces the flow
• Some painkillers, such as ibuprofen, may reduce menstrual flow

Talk to your doctor about the different options available to you!