Heavy periods (menorrhagia)
Heavy menstrual bleeding is bleeding that affects your quality of life — soaking pads or tampons every hour, flooding, large clots, or bleeding lasting more than 7 days. Common causes include fibroids, hormonal imbalance, adenomyosis, polyps, and clotting disorders. A GP assessment with blood tests and pelvic ultrasound identifies the cause and effective treatments are available.
Key information
- Symptom
- Heavy periods
- Category
- Women's health
- Common possible causes
- Fibroids, Adenomyosis, Endometrial polyps, Hormonal imbalance (perimenopause, PCOS, anovulatory cycles)
- Tests that may be considered
- Full blood count, Ferritin, TSH, Coagulation screen where indicated
- Clinic assessment
- Available same day
- Home doctor visit
- Available across Dubai
- Home blood test
- Available across Dubai
- Date reviewed
- 2026-07-01
What this symptom means
Heavy menstrual bleeding is bleeding heavy enough to affect physical, social or emotional quality of life.
Common possible causes
- · Fibroids
- · Adenomyosis
- · Endometrial polyps
- · Hormonal imbalance (perimenopause, PCOS, anovulatory cycles)
- · Thyroid dysfunction
- · Copper IUD
- · Bleeding / clotting disorders
Less common possible causes
- · Endometrial hyperplasia
- · Pelvic inflammatory disease
- · Anticoagulant medication
Serious causes that must not be missed
- · Endometrial cancer (especially with postmenopausal bleeding)
- · Severe iron deficiency requiring transfusion
- · Bleeding between periods or after intercourse
- · Postmenopausal bleeding
- · Very heavy bleeding causing dizziness or fainting
- · Sudden change in bleeding pattern
Call 998 (UAE ambulance) or attend the nearest emergency department for any of the above.
When a same-day GP is appropriate
- · Heavy bleeding with dizziness, fainting or breathlessness
- · Postmenopausal bleeding
When a routine GP appointment is fine
- · Persistent heavy periods for review
- · Fibroid or adenomyosis-related bleeding
- · Perimenopausal heavy bleeding
Questions a doctor may ask
- · How many days do you bleed and how heavy?
- · Are you passing large clots or flooding?
- · Any bleeding between periods or after sex?
- · Any pain with periods?
- · How is your energy — do you feel tired or breathless?
- · Which contraception do you use?
- · Any family history of bleeding disorders?
History factors that may matter
- · Fibroids or endometriosis
- · PCOS
- · Perimenopause
- · Anticoagulant use
- · Family history of bleeding disorders
Medicines that may contribute
- · Anticoagulants
- · Copper IUD
Never stop a prescribed medication without discussing it with a clinician.
What may happen during the examination
- · Abdominal and pelvic examination
- · Speculum examination and cervical screening if due
- · Assessment for anaemia
Tests that may be considered
Blood tests
- · Full blood count
- · Ferritin
- · TSH
- · Coagulation screen where indicated
- · Hormonal profile if perimenopausal
Other tests
- · Pelvic ultrasound
- · Endometrial biopsy in higher-risk cases
When a specialist referral may be considered
- · Gynaecology for fibroids, adenomyosis, polyps, or bleeding not responding to first-line treatment
- · Urgent referral for postmenopausal bleeding
Possible treatment approaches
- · Tranexamic acid during periods
- · Mefenamic acid (NSAID) during periods
- · Combined pill or progestogen-only options
- · Levonorgestrel-releasing IUS (Mirena) — highly effective
- · Surgical options — polyp removal, endometrial ablation, myomectomy, hysterectomy
- · Iron replacement for anaemia
Safe self-care
- · Track your cycle and bleeding pattern
- · Iron-rich diet — meat, fish, leafy greens, legumes
- · Regular exercise and adequate sleep
Best avoided
- · Accepting heavy periods as ‘normal’ when they affect your life
- · Aspirin during heavy periods (worsens bleeding)
How Aafiyah can help
- · Female GP assessment in clinic or at home
- · Home blood testing including iron studies
- · Pelvic ultrasound referral
- · Prescription of medical treatments and gynaecology referral
Related tests
Related conditions
Related symptoms
Frequently asked questions
When are periods considered heavy?+
Periods are heavy when they affect your quality of life — soaking a pad or tampon every hour, flooding, passing large clots, or lasting more than 7 days. Iron deficiency is common and should be checked.
What tests are done for heavy periods?+
Typical assessment: full blood count, ferritin, TSH, hormonal profile if perimenopausal, and pelvic ultrasound. A coagulation screen is done where a bleeding disorder is suspected.
Do I need surgery for heavy periods?+
Not usually — most heavy bleeding responds to medical treatment such as tranexamic acid, hormonal options or the Mirena IUS. Surgery is reserved for cases where medical treatment does not help.
Medical references
- · NICE — Heavy menstrual bleeding (NG88) — nice.org.uk
- · NHS — Heavy periods — nhs.uk
Medically reviewed by: Dr Shahbaz Afzal — British-trained Family Medicine Consultant, DHA-licensed
Written: 2026-07-01 · Reviewed: 2026-07-01 · Next review: 2027-01-01
This page provides general medical information for people in Dubai and the UAE. It does not replace personal medical advice, diagnosis or treatment. Always seek the advice of a qualified clinician about any medical concern.
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