Menorrhagia

Key facts

• Menorrhagia means menstrual bleeding that's unusually heavy, prolonged, or both, one of the most common complaints seen in women's health care.
• It matters medically when blood loss is significant enough to cause fatigue, iron-deficiency anaemia, or to interfere with ordinary activities.
• The best-evidenced non-hormonal treatment is tranexamic acid, which stabilises clots and can cut menstrual blood loss by roughly 40-50%, taken only on the heavy days of a cycle.
• Heavy periods can signal an underlying condition such as fibroids or a thyroid problem, so persistent heavy bleeding is worth investigating.

What counts as heavy bleeding

There's no need to measure blood loss precisely to know if a period is heavy: soaking through a pad or tampon every hour for several hours in a row, needing to double up on protection, passing clots larger than a coin, or bleeding for more than seven days are all signs worth acting on. Many women live with heavy periods for years before seeking help, assuming it's simply normal for them, but persistent heavy bleeding is common and treatable, not something to just tolerate.

Reducing blood loss

Tranexamic acid, an antifibrinolytic agent, is the most evidence-backed non-hormonal option. It stabilises clots and can cut menstrual blood loss by roughly 40-50%. Because it's taken only on the heavy days of a cycle, it's straightforward to combine with other treatments if needed.

When to seek further assessment

Heavy periods can be a sign of an underlying cause such as uterine fibroids, adenomyosis, a coagulation disorder, or a thyroid problem. A gynaecologist can investigate with a pelvic ultrasound and blood tests. Seek prompt care if bleeding is severe enough to soak through protection hourly for several hours, or if you feel faint or unusually breathless.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.