What’s the lowdown?

• Changing a tampon every couple of hours and bleeding through clothing can mean you have heavy periods
• Heavy periods are common and often have no underlying cause, but treatments are available
• Endometriosis, fibroids, pelvic inflammatory disease and polycystic ovary syndrome can all cause heavy periods
• Heavy periods do not cause infertility, but they can be a symptom of conditions linked to fertility issues
• Those with heavy periods may be at risk of anaemia
• Tranexamic acid is a non-hormonal treatment for heavy periods

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What are heavy periods?

Did you know that people who menstruate can lose around 5 – 12 teaspoons of blood every month? For some, they may lose more than 12 teaspoons. But what does this really mean? What do twelve teaspoons of blood look like when using tampons and sanitary towels? And how do you know if your periods are heavy?

To figure out whether you have heavy periods, you may wish to consider the following:

• Do you change a tampon or pad every couple of hours?
• Do you need to empty your menstrual cup sooner than the instructions suggest?
• Do you often bleed through clothes and use two different products to better protect against leakage?

If the answer is ‘yes’, you may have heavy periods –  or menorrhagia, to give it its technical term. Heavy periods with blood clots larger than 2.5cm and bleeds lasting longer than seven days all indicate heavy bleeding periods. In essence, periods that are heavy enough to disrupt your normal daily life and require your attention.

Why are my periods so heavy?

Eliminating an underlying cause for heavy periods should be your first port of call. Polycystic ovary syndrome (PCOS), endometriosis, fibroids and pelvic inflammatory disease (PID) are all possibilities. So consider a trip to your GP to rule these conditions out. It is not uncommon for periods to be heavy, and this may be what’s normal for you. That doesn’t mean you have to suffer in silence, however. Treatment options – such as tranexamic acid – are available to you.

Is it normal to have heavy periods?

When you first start your period, you may experience heavy bleeds. Likewise, after pregnancy and during the menopause, heavy periods can be normal. For others, no obvious cause has been found. Menorrhagia is common and could just be how your periods are, but for some people this can impact on their mood and physical health, and can significantly affect daily life. So it’s important to be aware of which treatment options are available – more on this in a moment.

Do heavy periods affect fertility?

There are many elements to be considered when looking at factors that can impact fertility, including alcohol intake, smoking, weight and age. Whilst heavy periods themselves do not cause infertility, they can be a symptom of other conditions which are linked to problems with conceiving. Blocked fallopian tubes from PID, and the absence of regular ovulation in PCOS and endometriosis are all common causes of fertility problems. As previously mentioned, these can be a cause of heavy periods. Complications due to fibroids may result in fertility problems, but only in rare circumstances.

Polycystic ovary syndrome impacts ovulation and prevents the regular release of an egg, which can make conception trickier – however with treatment, most women are able to conceive. Pelvic inflammatory disease, or PID, is most commonly caused by a sexually transmitted infection, such as gonorrhoea or chlamydia. It often causes no symptoms but can result in the scarring and narrowing of the fallopian tubes. This creates a challenge for the egg to pass through the tubes to the womb from the ovaries and increases the risk of an ectopic pregnancy. Pelvic inflammatory disease can lead to issues with fertility, particularly in those who delay seeking treatment. (Another great reason to book that STI check-up!)

When to worry about heavy periods

In rare circumstances, heavy periods can be a sign of womb cancer. It’s important to see a doctor if you’ve had heavy periods for a while, if your periods are extremely painful, if you experience bleeding between periods or after sex, and if your heavy periods are accompanied by pain during sex, peeing or pooing.

Due to the larger loss of blood you experience during a heavy period, you may be at risk of anaemia. Known as an iron-deficiency, anaemia can lead to headaches, tiredness and breathlessness. A simple blood test carried out by your doctor can determine if this is an underlying cause.

You should also see a doctor if your periods are interfering with your everyday life and are causing you distress. We have a great team of doctors here at The Lowdown who are passionate about women’s health and helping you. You never have to suffer in silence, our GPs are always here to listen to your concerns. Booking an appointment is easy, convenient and you’ll wish you’d done it sooner! We also have an excellent pelvic health physiotherapist who can offer advice on managing conditions like endometriosis, which can cause heavy periods.

Treatment for heavy periods

Dreading every month due to the worry of really heavy periods is a misery you don’t have to endure – we will soon be offering tranexamic acid right from The Lowdown’s shop to help you manage painful and heavy periods!

Tranexamic acid is a non-steroidal, anti-inflammatory drug (NSAID) used in the treatment of heavy periods. It is a non-hormonal option, perfect for those looking to avoid hormonal treatments. It works to control bleeding by helping the blood to clot, and is available to buy for over-18s from The Lowdown. Tranexamic acid reduces menstrual blood loss by up to 50%. It is only taken for a short time each month to control your monthly bleeding. Usually this is two (500mg) tablets taken three to four times a day, for the first three to four days of your period.

The hormonal coil (IUS) is another effective treatment for heavy periods. By releasing progestogen, the lining of the womb is thinned. Periods become lighter, less frequent, and may stop completely. The IUS should not be confused with the IUD, aka the copper coil. This can have the opposite effect and sometimes makes periods heavier! The copper coil is an effective contraception and a great non-hormonal choice, but is best avoided by those experiencing heavy periods.

Evidence shows that the use of combined hormonal contraceptives results in lighter periods. The combined pill, the patch, and vaginal ring can all be used to help manage heavy periods and period pain. It may also be beneficial to use combined hormonal contraceptives continuously, avoiding withdrawal bleeds, with studies showing an advantage over the more traditional cyclical use (with breaks) in the short term. Tranexamic acid is generally safe and can be taken with most other medicines, however you should speak to your doctor or pharmacist if you’re taking the combined pill as there could be a very small increased risk of getting a blood clot if you take tranexamic acid as well. We’re really excited that tranexamic acid will soon be available to buy directly from The Lowdown! Keep an eye out for updates.

In the mean time, investing in some period pants could make a big difference to your heavy periods. Period pants, such as Modibodi or WUKA, are a sustainable form of menstrual care that can be washed and re-used. Modibodi in particular can hold up to 3-4 tampons worth of blood in the lining!