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Heavy Periods, Painful Cramps & More: When Your Period Is Telling You Something

Understanding Heavy Periods, Cramps and Your Menstrual Health

8/17/20263 min read

Periods are a normal part of life, but that doesn't mean you have to accept severe pain, very heavy bleeding or disruptive menstrual symptoms as simply something you have to live with.

Many women become accustomed to their own cycle and may not realise that symptoms they've considered “normal for me” could be worth discussing with a healthcare professional. Sometimes there is no underlying problem at all, but persistent or significant symptoms can occasionally be associated with a condition that deserves investigation.

Heavy periods aren't always “just heavy periods”

Menstrual flow varies considerably between women, and having a naturally heavier period does not necessarily mean that something is wrong. However, bleeding can be considered heavy when it regularly interferes with your everyday life — for example, needing to change period products every 1–2 hours, bleeding for more than 7 days, passing large blood clots, bleeding through clothing or bedding, or feeling tired or short of breath.

There are many possible reasons for heavy menstrual bleeding. These can include fibroids, polyps, adenomyosis, endometriosis, hormonal changes affecting ovulation, thyroid problems, polycystic ovary syndrome (PCOS), certain medications or contraceptives, and bleeding disorders. Sometimes, no specific underlying cause is found.

Fibroids, for example, are common non-cancerous growths in or around the womb and can cause heavy or painful periods. Polyps are growths arising from the lining of the womb and can also contribute to abnormal bleeding.

Heavy bleeding can also leave you feeling exhausted. Losing significant amounts of blood over time can contribute to iron deficiency and anaemia, so persistent tiredness, weakness or breathlessness alongside heavy periods is worth discussing with your GP.

Severe period pain deserves attention too

Some period pain is common. The womb naturally contracts during menstruation, which can cause cramping. But severe pain that affects your ability to work, sleep, exercise or carry on with normal activities should not simply be dismissed as something you have to endure.

Conditions including endometriosis and adenomyosis can cause particularly painful periods. Endometriosis occurs when tissue similar to the lining of the womb grows elsewhere in the body, while adenomyosis occurs when this tissue grows into the muscular wall of the womb. Both can be associated with painful and/or heavy periods.

Other symptoms can provide useful clues. Pain during sex, pain when opening your bowels or passing urine, persistent pelvic pain, unusually heavy bleeding or pain that progressively worsens are all worth mentioning to a healthcare professional.

What about hormones?

Hormones play an important role in regulating the menstrual cycle, and changes in hormonal signalling can affect when you ovulate, how regularly you menstruate and how much you bleed.

Irregular or absent ovulation can result in irregular or sometimes heavy bleeding. Hormonal conditions such as PCOS and thyroid disorders can also affect menstrual patterns.

However, it's important not to assume that every menstrual problem is caused by a vague “hormonal imbalance.” There are many possible explanations for changes in your cycle, and sometimes a physical condition affecting the womb or pelvis is involved. Finding the underlying reason, where possible, is much more useful than simply trying to correct a symptom without understanding why it is happening.

Don't just learn to live with symptoms

One of the most useful things you can do is pay attention to your own pattern.

Keep a record for a few cycles of:

  • when your period starts and finishes

  • how heavy your bleeding is

  • how frequently you need to change period products

  • whether you pass large clots

  • when pain begins and how severe it becomes

  • whether pain occurs outside your period

  • any bleeding between periods or after sex

  • changes in your cycle length

  • other symptoms such as fatigue, dizziness, bloating or pain during sex

A symptom diary can give your GP a much clearer picture of what is happening and when.

If your periods have become heavier, more painful or irregular, or your symptoms are affecting your everyday life, it is reasonable to seek medical advice. Depending on your symptoms, your clinician may consider examinations, blood tests or imaging such as an ultrasound, and treatment will depend on the underlying cause.

Looking after yourself while you investigate

Getting investigated doesn't mean that something serious will necessarily be found. Many causes of menstrual symptoms are common and treatable, and sometimes investigations do not identify a specific underlying condition.

The important point is that you don't have to choose between accepting your symptoms and immediately assuming something is wrong. You can take your symptoms seriously while also recognising that menstrual variation is normal.

There are medical treatments available for heavy bleeding and painful periods, and the right option depends on the cause, your symptoms, your health and whether you are planning a pregnancy.

Your menstrual cycle can provide useful information about your health. Paying attention to changes, keeping track of symptoms and seeking appropriate advice can help you understand your body better — and, importantly, help you find solutions that are right for you.

You do not have to simply put up with menstrual symptoms that are significantly affecting your quality of life.