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Heavy periods

How do doctors diagnose heavy periods?

If you think your periods are too heavy, your doctor can probably help you.

If you do have heavy periods, your doctor may try to find out why. Knowing the cause can help you decide on the best treatment.

When you go to your doctor, he or she will probably:

Ask you about your periods
Examine you
Suggest some tests. Sometimes women with heavy periods need to be referred to a specialist.

Questions your doctor may ask

Do you need to wear tampons and pads at the same time to handle the blood loss?
Do you have to get up in the night to change your protection?
Do you bleed into your bedding while you are asleep, despite wearing tampons and pads?
Do you have "floods" (sudden, heavy flows of blood that soak your underwear and possibly your clothes)?
How long do your periods last?
Do you pass clumps of blood (clots) during your period?
Do you stay home during your periods because you are worried that you won't get to a bathroom in time to change your tampon or pad when you are out?
What other effects do your periods have on your life? For example, how do they affect your work, family and social life?
How long have you had these symptoms?

By asking questions like these, your doctor can get an idea of how heavy your periods are and how much they are disrupting your life.

Your doctor may also ask you to keep a chart of your blood loss to help show how heavy your periods are. This is a kind of diary, in which you record how many tampons and pads you're using each day, how heavily blood-stained they are, and whether you pass blood clots.

Tests your doctor may suggest

Your doctor may need to examine you or do some tests. This may depend on whether your periods are regular (the number of days between your periods is about the same each time) or irregular (the number of days varies a lot).

Your doctor may give you:

A pelvic examination: Your doctor may feel your womb from inside and outside your body to check for growths (called

fibroid
A fibroid is a lump of extra tissue that can build up in the wall of your womb. Sometimes it can grow big enough to feel. It can cause pain and bleeding, and make it difficult for a fertilized egg to take hold in your womb. If these problems become too bad, you can have fibroids removed by surgery.

fibroids). This shouldn't hurt, but may be slightly uncomfortable.
A Pap smear: This test can be uncomfortable and slightly painful, but it takes only a minute or two. You lie down on your back with your knees up and apart. A doctor or nurse holds your vagina open with an instrument called a

vaginal speculum
A vaginal speculum is the tool doctors put into a woman's vagina when they need to examine the inside.

speculum. He or she then scrapes some cells from your

cervix
The cervix is a piece of tissue that sits between a woman's womb and her vagina. It has a small opening in it that gets much bigger when a woman is having a baby.

cervix. The cells are sent to a laboratory to be looked at under a microscope. Doctors use the Pap smear to check for infections of the cervix and changes in cells that could become cancerous if they're not treated.

A blood test

If your periods are heavy but regular, with no bleeding in-between, your doctor will probably recommend a blood test. This is to check that you have a normal number of

red blood cells
Red blood cells are the part of your blood that makes it red. Their main job is to carry oxygen from your heart and lungs out to the tissues of your body. Once these cells unload oxygen, they pick up carbon dioxide. They take carbon dioxide back to your lungs so you can breathe it out of your body.

red and

white blood cells
White blood cells are the cells in your blood that help your body fight infections. The other cells in your blood, red blood cells, carry oxygen around your body.

white blood cells and

platelets
Platelets are small disc-shaped particles found in your blood (along with red blood cells and white blood cells). Platelets form the clots that stop the bleeding when you've been cut. People who don't have enough platelets have problems with bleeding too much.

platelets in your blood. If you lose a lot of blood during your period, you can get a condition called

anemia
Anemia is when you have too few red blood cells. Anemia can make you get tired and breathless easily. It can also make you look pale. Anemia can be caused by a number of different things, including problems with your diet, blood loss and some diseases.

anemia. Anemia is caused by a lack of red blood cells, and it can make you feel tired and weak. You may need treatment, such as iron tablets, to help you make more red cells.

Seeing a specialist

Your doctor may decide to refer you to see a specialist. This is most likely to happen if:

Your bleeding is irregular. To read more, see Irregular bleeding
You might have a condition that affects your reproductive system or a disease in another part of your body
The medicines prescribed by your doctor haven't helped you
You are thinking about having an operation to treat your heavy periods.

How quickly you will be seen by a specialist will depend on what your doctor thinks the problem is.

This information was last updated on Sep 01, 2008

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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