Heavy bleeding

Heavy bleeding affects at least 20% of women. The average woman bleeds for 5 to 7 days and has a period every 4 weeks. Bleeding is considered abnormal if it lasts longer than 7 days or occurs more often than 21 days. Bleeding is considered HEAVY if a woman is soaking through a pad or tampon every 1-2 hours, waking up at night to change, or bleeding onto her clothes during the day.

The first few years after menarche (a woman’s first period) and the last few years before menopause (a woman’s last period) are often abnormal. This is typical because the ovaries are not working at their full potential. Heavy bleeding at other times in a woman’s reproductive life should be evaluated.

Causes of heavy uterine bleeding:

  • Pregnancy – normal, miscarriage or ectopic
  • Infection – of vagina, cervix or uterus
  • Fibroids – benign tumors in uterus
  • Adenomyosis – invasion of uterine lining into the uterine muscle
  • Medical problems – thyroid or diabetes
  • Blood clotting disorder – bruising, bleeding gums or nose
  • Cancer – cervix, uterus or vagina


After thorough discussion of your medical history, your provider will do a pelvic exam to evaluate the vulva, vagina, cervix, uterus and ovaries. You may have your blood tested for anemia, pregnancy, or problems with hormones, thyroid or clotting. You may need to have an ultrasound or an endometrial biopsy to evaluate the cells inside the uterus.


Depending on your tests and your particular situation, your provider will recommend a treatment that may include medication, Mirena IUD, Novasure ablation or surgery.