Heavy menstrual bleeding (HMB) is menstrual bleeding that is excessive and interferes with a woman’s physical, emotional, social, educational or work life. It is not simply about how many pads or tampons are used. If periods are affecting your daily activities, causing you to miss work or school, or making you plan your life around your cycle, it may be considered heavy menstrual bleeding.

Heavy menstrual bleeding is one of the most common gynaecological conditions affecting women who menstruate. However, many women delay seeking help because they believe their experience is "normal" or have never discussed what a typical menstrual period looks like.

If you're unsure whether your menstrual bleeding is normal or heavy, you can complete the free MyFlowCheck™ questionnaire. MyFlowCheck™ helps identify symptoms associated with heavy menstrual bleeding, iron deficiency, anaemia and bleeding disorders, and provides a report that you can discuss with your healthcare provider.

You may have heavy menstrual bleeding if you:

Need to change a pad, tampon, menstrual cup or period underwear very frequently.

• Bleed through clothing or bedding.

• Need to use more than one menstrual product at a time.

• Pass large blood clots.

• Need to wake during the night to manage bleeding.

• Have periods lasting longer than seven days.

• Avoid work, study, sport or social activities because of your period.

• Experience fatigue or symptoms of iron deficiency.

If any of these sound familiar, it is worth discussing them with your GP or healthcare provider.

Heavy menstrual bleeding can have many causes, including:

• Hormonal changes.

• Fibroids or polyps.

• Endometriosis or adenomyosis.

• Thyroid disorders.

• Certain medications.

• Iron deficiency.

• Inherited bleeding disorders.

• Other medical conditions affecting blood clotting.

Sometimes more than one factor is involved.

Bleeding disorders are conditions that affect the body's ability to form blood clots properly. This can lead to prolonged or excessive bleeding after injury, surgery, dental work, childbirth or during menstruation.

The most common inherited bleeding disorder is von Willebrand disease, but there are many other clotting and platelet disorders. In Australia, the Haemophilia Foundation Australia provides information and support for people living with VWD, haemophilia and other inherited bleeding disorders.

Yes.

Heavy menstrual bleeding is often one of the earliest signs of an inherited bleeding disorder. If you have concerns about your bleeding symptoms, MyFlowCheck™ can help identify signs that may warrant discussion with your GP or referral for further assessment.

Other signs that may suggest a bleeding disorder include:

• Easy bruising.

• Frequent nosebleeds.

• Excessive bleeding after surgery or dental procedures.

• Prolonged bleeding from cuts.

• Family members with similar bleeding symptoms.

Iron deficiency occurs when your body's iron stores become depleted.

Iron is needed to:

• Produce healthy red blood cells.

• Carry oxygen throughout the body.

• Support energy levels.

• Maintain concentration and cognitive function.

• Support immune function.

Heavy menstrual bleeding is a common cause of iron deficiency in women of reproductive age.

Iron deficiency anaemia develops when iron deficiency becomes severe enough to reduce haemoglobin levels and the body's ability to transport oxygen effectively.

Symptoms may include:

• Fatigue and low energy.

• Brain fog or difficulty concentrating.

• Dizziness.

• Headaches.

• Shortness of breath.

• Reduced exercise tolerance.

• Pale skin.

• Restless legs.

• Hair loss or brittle nails.

Some people have significant iron deficiency even before anaemia develops.

If you experience symptoms such as fatigue, dizziness or prolonged heavy periods, completing MyFlowCheck™ may help identify whether iron deficiency or anaemia could be contributing to your symptoms before discussing testing with your healthcare provider.

Testing may include:

• Full blood count (FBC).

• Ferritin (iron stores).

• Other iron studies if appropriate.

Your doctor will decide which tests are most suitable.

You should seek medical advice if:

• Your period affects your daily life.

• You think your bleeding is heavier than normal.

• You experience symptoms of iron deficiency or anaemia.

• You are concerned about a possible bleeding disorder.

• Your periods have changed significantly.

• You are bleeding between periods.

• You experience severe pain.

• You are planning surgery or pregnancy and have a history of heavy bleeding.

If you are experiencing any of these symptoms, completing MyFlowCheck™ before your appointment may help you better describe your symptoms and support conversations with your healthcare provider.

Treatment depends on the underlying cause and your individual circumstances.

Options may include:

• Iron supplementation.

• Hormonal treatments.

• Non-hormonal medications.

• Treatment of underlying gynaecological conditions.

• Management of bleeding disorders.

• Surgical procedures in selected cases.

A personalised treatment plan should be developed with your healthcare team.

Bringing your MyFlowCheck™ report to your appointment may help guide discussions about testing, diagnosis and treatment options.

Helpful questions include:

• What might be causing my heavy bleeding?

• Should I be tested for iron deficiency or anaemia?

• Could I have a bleeding disorder?

• What treatment options are available?

• What are the benefits and risks of each option?

• What happens if I choose not to have treatment?

• Should I see a specialist?

Resources such as Choosing Wisely Australia's "5 Questions" can also help prepare for appointments.