What it is
Heavy means soaking a pad or tampon every hour. Or bleeding past seven days. Or clots bigger than a quarter.
Heavy bleeding is a symptom, not a diagnosis. Fibroids, polyps, adenomyosis, a clotting disorder, a thyroid problem or a hormone shift can all cause it. The workup sorts out which.
Losing that much blood every month drops your iron. That is usually where the fatigue comes from.
What you might notice
- Soaking a pad or tampon in an hour or less
- Doubling up on protection, or setting an alarm to change at night
- Clots larger than a quarter
- Bleeding that runs past seven days
- Planning your week around a bathroom
- Tiredness, breathlessness on stairs, or looking pale
- Bleeding between periods
- Periods getting heavier year over year
How Dr. Mueller finds the cause
- 1
Your bleeding history
How much, how long, how often, and what it stops you doing.
- 2
Pelvic exam
Checks the size and shape of the uterus.
- 3
Blood tests
Blood count, iron, thyroid, and a pregnancy test.
- 4
Pelvic ultrasound
Done in the office, looking for fibroids, polyps and adenomyosis.
- 5
Endometrial biopsy
A sample of the lining, if your age or bleeding pattern calls for it.
- 6
The plan
Dr. Mueller lays out the options and you choose one.
Questions people ask
- How heavy is too heavy?
- Soaking a pad an hour, clots bigger than a quarter, or bleeding past seven days. Any one of those is reason enough to come in.
- Does this mean I need a hysterectomy?
- Usually not. Most heavy bleeding is handled with medication, a hormonal IUD, an ablation, or removing a polyp or fibroid.
- Can heavy periods make me anemic?
- Yes, and it is common. Dr. Mueller checks your blood count and iron at the first visit.
- Will I still be able to get pregnant?
- That depends on the cause and the treatment. Tell Dr. Mueller if you want children. It changes the options.
- Does the ultrasound hurt?
- No. A slim probe goes in the vagina for about ten minutes. Most people find it uncomfortable rather than painful.
- What should I do before my visit?
- Track two cycles. Write down the days you bleed and how often you change protection.