The specialists at North Carolina OB/GYN & Midwifery know that heavy menstrual bleeding (HMB) is more than just an inconvenience — it can significantly impact daily life, from missed work and school days to ongoing fatigue and discomfort. If you’re soaking through a pad or tampon every hour for several hours, passing large clots, or feeling constantly drained during your cycle, you may be experiencing HMB.
The good news? Heavy periods are common and treatable. With the right guidance and treatment plan, most people find effective relief. In the following sections, we’ll discuss the causes, diagnosis, and treatment options for heavy menstrual bleeding, while also offering practical tips for managing symptoms at home.
Understanding Heavy Menstrual Bleeding
So, what qualifies as “heavy” menstrual bleeding? While flow varies for everyone, doctors often define HMB as:
- Bleeding that soaks through a pad or tampon every hour for several consecutive hours
- Needing to use double protection or waking up at night to change products
- Passing clots larger than a quarter
- Periods lasting longer than seven days
Common symptoms and complications include:
- Fatigue or weakness
- Iron-deficiency anemia
- Disrupted daily activities or sleep
Possible causes include:
- Hormonal imbalances (such as excess estrogen or low progesterone)
- Fibroids or uterine polyps
- Bleeding disorders
- Side effects of medications like blood thinners
- Underlying medical conditions such as thyroid disorders
If your bleeding is disrupting your life or leaving you feeling weak or dizzy, it’s time to see a healthcare provider.
Diagnosis and Evaluation
A personalized diagnosis is key to finding the right treatment. During an evaluation, a healthcare provider may:
- Review your medical history and menstrual patterns
- Perform a physical and pelvic exam
- Order blood tests to check for anemia or clotting issues
- Use imaging (such as ultrasound) to look for fibroids, polyps, or structural causes
- Recommend an endometrial biopsy in certain cases to check uterine lining cells
This step ensures your treatment plan addresses not just the bleeding but also the underlying cause.
Lifestyle and Home Management Tips
While medical treatment is often necessary, these strategies can help manage symptoms day to day:
- Track your cycle: Note the number of pads/tampons used, clots passed, and days of bleeding.
- Focus on nutrition: Incorporate iron-rich foods like spinach, lean red meat, beans, and fortified cereals. Supplements may also be recommended.
- Prioritize rest and stress management: Yoga, meditation, or light exercise may help regulate hormones.
- Choose the right menstrual products: Pads, tampons, or menstrual cups — experiment to see which works best during heavy flow.
Medical Treatment Options for HMB
Depending on your diagnosis, doctors may recommend:
Non-hormonal options:
- NSAIDs (e.g., ibuprofen or naproxen) — help reduce both bleeding and cramps.
- Tranexamic acid — a prescription medication that reduces menstrual blood loss.
Hormonal options:
- Combined oral contraceptives — regulate cycles and reduce bleeding.
- Progesterone-only treatments — balance hormones to decrease flow.
- Hormonal IUD (levonorgestrel-releasing) — a highly effective, long-term option that reduces or even eliminates periods for some.
Procedural and Surgical Options for Heavy Menstrual Bleeding
For persistent cases or when fibroids/polyps are present, procedures may be recommended:
- Endometrial ablation: Minimally invasive procedure that reduces or destroys the uterine lining.
- Myomectomy or polypectomy: Surgical removal of fibroids or polyps causing heavy bleeding.
- Hysterectomy: A definitive solution for those who have completed childbearing and want permanent relief from heavy bleeding.
Recovery times and fertility implications vary, so it’s important to discuss these in detail with your provider.
When to See a Healthcare Provider for Heavy Menstrual Bleeding
Make an appointment if you experience:
- Persistent heavy bleeding despite at-home measures
- Symptoms of anemia (fatigue, dizziness, shortness of breath)
- Bleeding between periods or after intercourse
- Severe pelvic pain or new changes in your cycle
Prompt evaluation ensures the right treatment and prevents complications.
Take Control of Your Menstrual Health with a Consultation
Heavy menstrual bleeding can feel overwhelming, but you don’t have to live with it. Effective solutions — from lifestyle adjustments and medications to minimally invasive procedures — are available to help you regain comfort and control.
A proud part of the UNC Health system, North Carolina OB/GYN & Midwifery has locations in Wakefield, Raleigh, Cary, and Holly Springs—contact us today for a consultation. If you’re struggling with heavy bleeding during periods, our team of OBGYN specialists will help you find relief with personalized care every step of the way.