Heavy Periods Gdańsk – Causes, Assessment and Treatment

Heavy periods, frequent leaks, large blood clots or bleeding that disrupts your daily life are worth discussing with a gynaecologist. You do not have to accept these symptoms as simply normal for you. Appropriate investigations can help identify the cause and guide treatment.

At Tartaczna 2 Medical Centre in Gdańsk, consultations are provided by Dr Marek Korożan, Dr Dominika Kozikowska and Dr Volha Khitrun. Our centre is located at 2 Tartaczna Street in Śródmieście, central Gdańsk.

When is a period too heavy?

Heavy menstrual bleeding is bleeding that adversely affects your health, activities or quality of life. You do not need to measure your blood loss in millilitres before seeking help.

Signs that your periods may be too heavy include:

• frequently needing to change fully soaked pads or tampons, for example every 1–2 hours;
• needing to use two types of protection together or getting up at night to change them;
• bleeding through your clothes or bedding;
• repeatedly passing large blood clots;
• limiting work, physical activity or leaving home because of bleeding.

Prolonged bleeding, particularly when it lasts more than a week or noticeably longer than usual, also needs assessment. However, a heavy period can be short: the amount of bleeding and its duration are different features.

Very heavy bleeding: when do you need urgent help?

If you are fully soaking a pad or tampon approximately every hour for at least 2 consecutive hours, you need an urgent medical assessment. If you also feel dizzy, faint, short of breath, have chest pain or feel markedly weak, attend an emergency department or call 112. Do not wait for a routine appointment.

Heavy bleeding when pregnancy is possible, particularly with abdominal pain or fainting, also requires urgent care. Bleeding associated with pregnancy or the postnatal period is not a menstrual period and needs separate assessment.

What can cause heavy periods?

The cause is not always hormonal. Possible causes include:

• Uterine fibroids and polyps: particularly those affecting the uterine cavity.
• Adenomyosis: tissue similar to the womb lining within the muscular wall of the uterus, often associated with painful periods as well.
• Ovulation disorders: for example, in polycystic ovary syndrome (PCOS) or during perimenopause.
• Bleeding disorders: such as von Willebrand disease.
• Certain medicines: particularly anticoagulants.
• A copper intrauterine device (IUD): this can make menstrual bleeding heavier.
• Conditions affecting the endometrium: including endometrial hyperplasia and, less commonly, cancer of the womb lining.

The assessment also considers other medical conditions, such as an underactive thyroid. Sometimes no visible abnormality is found in the uterus, even though the bleeding requires treatment.

Heavy bleeding does not mean that you have cancer. However, assessment of the endometrium should not be overlooked when symptoms or risk factors indicate that it is needed.

Heavy periods with blood clots: should you be concerned?

Small blood clots can occur during a period. Large or frequent clots, particularly alongside heavy bleeding, leaks and weakness, should be discussed with a doctor.

The appearance of the clots alone cannot identify the cause. It does not establish whether you have a fibroid, polyp, bleeding disorder or another specific condition.

How are heavy periods investigated?

Medical history and gynaecological examination

Your doctor will ask about the length and regularity of your cycles, how long bleeding lasts, blood clots, pain, and bleeding between periods or after sex. Your contraception, medicines and pregnancy plans are also important.

Mention if your periods have been heavy since you first started menstruating, or if you also bruise easily, have nosebleeds or bleed for a long time after procedures. These features may justify investigations for a bleeding disorder.

Blood tests

A full blood count is a basic investigation used to assess haemoglobin levels and check for anaemia. Depending on your circumstances, your doctor may request ferritin, clotting tests or other investigations.

Not every patient needs a full hormone panel. Thyroid-stimulating hormone (TSH) and further thyroid tests are selected according to symptoms and medical history. If pregnancy is possible, this needs to be considered when investigating the bleeding.

Ultrasound and assessment of the endometrium

A transvaginal ultrasound scan helps assess the uterus, endometrium and ovaries. It may identify fibroids, features of adenomyosis or a suspected polyp, but it cannot exclude every abnormality.

In selected circumstances, a sample of the endometrium is needed for histopathological examination. Your doctor will determine whether an endometrial biopsy or hysteroscopy with a targeted biopsy is appropriate. An aspiration biopsy may be insufficient when a focal abnormality is suspected or symptoms persist.

Heavy periods, iron deficiency and anaemia

Repeated blood loss can deplete iron stores and eventually lead to anaemia. Symptoms may include tiredness, weakness, pale skin, palpitations and shortness of breath during exertion.

Treatment should address both the bleeding and any diagnosed deficiency. Your doctor will select the iron preparation, route of administration and duration of treatment. Follow-up blood tests are needed: taking iron for a fixed period without checking the response is not enough.

Heavy periods before the menopause

During perimenopause, changes in ovulation can cause irregular or heavy bleeding. However, this does not mean that every change is due to age alone. Polyps, fibroids and conditions affecting the endometrium still need to be considered.

Bleeding after the menopause is not a period. If bleeding occurs after at least 12 months without periods due to menopause, it needs medical assessment, even if it is light or has happened only once. If you use menopausal hormone therapy (HRT), the assessment also takes account of the type of treatment and how long you have been using it.

Hashimoto's disease, an underactive thyroid and heavy periods

Hashimoto's disease affects the thyroid and can cause hypothyroidism, or an underactive thyroid. Insufficient thyroid hormone can be associated with heavy or irregular periods.

Not every episode of bleeding should be attributed to Hashimoto's disease. Even when thyroid function is well controlled, a gynaecological assessment may still be needed. Thyroid tests are particularly relevant if you also experience sensitivity to cold, constipation, dry skin or unexplained weight gain.

Treatment for heavy periods: what are the options?

Treatment depends on the cause, symptom severity, investigation results, contraindications and whether you are planning a pregnancy.

Medicines and hormonal treatment

• A levonorgestrel-releasing intrauterine system (IUS): a suitable hormonal system can substantially reduce bleeding. It should not be confused with a copper IUD.
• Tranexamic acid: a non-hormonal option for reducing bleeding, prescribed after assessment of its suitability and contraindications.
• Non-steroidal anti-inflammatory drugs (NSAIDs): these can reduce bleeding and period pain in appropriately selected patients.
• Hormonal treatment: for example, combined hormonal contraception or progestogens, depending on the clinical situation.

These treatments are not suitable for everyone. Relevant considerations include a history of blood clots, kidney disease, gastrointestinal conditions and bleeding disorders. Do not stop anticoagulant medicines yourself.

Procedures and surgery

Removal may be considered for polyps or certain fibroids. If non-surgical treatment is ineffective or unsuitable, your doctor will discuss other options, including endometrial ablation or surgery.

Endometrial ablation is not suitable for women planning a pregnancy and is not a form of contraception. Dilatation and curettage alone is not a standard long-term treatment for persistent heavy periods.

Procedures requiring hospital care or a specialist centre are planned following an appropriate assessment.

How should you prepare for your consultation?

• Record the dates and duration of recent bleeding episodes.
• Note how often you change menstrual products, any leaks and whether you pass clots.
• Bring any existing full blood count, ferritin, ultrasound and histopathology results.
• Prepare a list of your medicines and details of your contraception.
• Tell your doctor whether you are planning a pregnancy.

You do not need to wait for another cycle before seeking advice. If bleeding is severe, assessing your safety takes priority over keeping a detailed bleeding diary.

Heavy periods: gynaecology consultations in Gdańsk

At Tartaczna 2 Medical Centre, menstrual disorders are assessed and treated by:

• Dr Marek Korożan;
• Dr Dominika Kozikowska;
• Dr Volha Khitrun.

During your appointment, the doctor will select appropriate investigations and discuss treatment options. Please contact reception to confirm current consultation fees and the cost of any additional tests.

Book an appointment at 2 Tartaczna Street in Gdańsk: call +48 58 719 10 25, visit our contact and booking page, or check available appointments on the Tartaczna 2 Medical Centre profile on ZnanyLekarz.