Seeing a GP
To try to find out what's causing your heavy periods, your GP will ask about:
- your medical history
- what your bleeding is like – for example, how long your periods normally last and how often you need to change sanitary products
- any related symptoms you have, like period pain or bleeding between periods
- what effect your bleeding is having on your everyday life
You'll also be asked about your family history to rule out inherited conditions that may be causing your heavy bleeding, such as Von Willebrand disease, which runs in families and affects blood clotting.
A full blood test should be offered to all women with heavy periods.
This can identify iron deficiency anaemia, which is often caused by heavy periods. If you have iron deficiency anaemia, you'll usually be prescribed iron tablets.
Some women may be offered an additional blood test to check for blood clotting disorders.
Your GP may suggest a physical examination to try to find the cause of your heavy bleeding.
You should be offered the option to be examined by a female doctor.
A physical examination involves the doctor:
- pressing on your tummy to feel for any abnormalities
- looking at your cervix by using an instrument called a speculum to hold open the walls inside your vagina
- feeling the inside of your vagina to identify whether your womb or ovaries are tender or enlarged
Before carrying out a pelvic examination, your doctor will explain the procedure to you and why it's necessary.
You should ask about anything you're unsure about. A pelvic examination should not be carried out without your consent.
If they have not been able to identify the underlying cause of your heavy periods, your doctor may refer you for further tests. These will check for abnormalities in the womb or ovaries, such as fibroids or adenomyosis.
These tests are usually done in hospital.
This is a procedure to examine the inside of your womb. It involves a narrow telescope with a light and camera at the end being passed into your womb through your vagina.
Images are sent to a monitor, so your doctor or specialist nurse can see inside your womb.
Sometimes a biopsy is carried out at the same time. This involves removing a small sample of womb lining for closer examination under a microscope.
Find out more about having a hysteroscopy.
You may be referred for an ultrasound scan of your womb as an alternative to hysteroscopy.
The ultrasound can be done from outside your body (pelvic ultrasound) or from inside your vagina (transvaginal ultrasound) depending on your circumstances.
For a transvaginal ultrasound, a small probe is inserted into your vagina to get a close-up image of your womb.