Heavy Periods (Menorrhagia): Causes and Treatment Options in India

Heavy Periods Are Common — but Not "Just Normal"

A surprising number of women assume their heavy periods are simply how their body works, and quietly put up with them for years. Some do have naturally heavier cycles. But heavy or prolonged bleeding is often a sign of a treatable underlying cause — and it should not be dismissed, especially when it is affecting your energy, your work, or your quality of life.

Across HSR Layout and Attibele, Dr. Sanjana L regularly meets women who had normalised bleeding heavy enough to cause anaemia. The message is simple: heavy periods deserve a proper look, not resignation.

What Counts as "Heavy"?

Bleeding is worth investigating when you:

• Soak through a pad or tampon every hour for several hours
• Need to change protection during the night
• Pass large blood clots
• Bleed for longer than seven days
• Feel tired, breathless or dizzy — signs of anaemia from blood loss
• Have to plan your life around your period

If any of these sound familiar, it is worth a conversation with a gynaecologist.

Common Causes of Heavy or Irregular Bleeding

Menorrhagia has several possible causes, which is why proper assessment matters:

• Hormonal imbalance — including thyroid problems and PCOS
• Uterine fibroids — a very common cause of heavy bleeding
• Uterine polyps — small growths in the uterine lining
• Endometriosis or adenomyosis
• Bleeding or clotting disorders
• Certain contraceptives — such as the copper IUD in some women
• Perimenopause — as hormones fluctuate before menopause

How the Cause Is Found

Investigation is straightforward and worth doing properly:

• A detailed history of your cycles and how bleeding affects daily life
• Blood tests for anaemia, thyroid function and hormonal causes
• A pelvic ultrasound to look for fibroids, polyps or PCOS
• A hysteroscopy where the uterine cavity needs closer assessment

Treatment Options

The good news is that most heavy bleeding responds well to treatment, and surgery is often not needed:

• Medical and hormonal treatment — tablets, hormonal IUDs or other options to reduce bleeding
• Treating the underlying cause — for example, managing thyroid or PCOS
• Minimally invasive procedures — keyhole surgery for fibroids or polyps, where they are the cause
• Iron correction — to reverse anaemia caused by blood loss

Treatment is always chosen with your fertility plans in mind. You can read more on our heavy and irregular periods treatment page. This article focuses on heavy bleeding; for the full range of period problems, see our menstrual disorders page.

Frequently Asked Questions

When are heavy periods a problem worth treating?

When you soak through protection hourly, pass large clots, bleed for more than seven days, or feel tired and breathless from blood loss — these point to a treatable cause.

What causes irregular periods?

Common causes include PCOS, thyroid problems, hormonal imbalance, stress, fibroids or polyps, and perimenopause. Tests and an ultrasound identify the specific cause.

Do heavy periods always need surgery?

No. Many cases respond to medical or hormonal treatment. Surgery — usually minimally invasive — is considered mainly when fibroids or polyps are the cause.

Can heavy periods cause anaemia?

Yes. Ongoing heavy blood loss is a common cause of iron-deficiency anaemia, which is why tiredness and breathlessness with heavy periods should be checked.

Consult Dr. Sanjana L

Dr. Sanjana L (MBBS, MS — OBG, Gold Medalist, FMAS) is a consultant obstetrician–gynaecologist and keyhole surgeon. If your periods are heavy enough to disrupt your life, they are worth investigating. Learn more about Dr. Sanjana, see her HSR Layout and Attibele clinics, or book an appointment.