About one third of women may experience heavy menses. If you have to use pads or tampons every hour, using two pads, a tampon with a pad, this is considered heavy. Also passing clots, soiling of the linen at night or a period lasting longer than a week is excessive. Sometimes there is dizziness, fatigue or cramps.
In cases of easy bruising, bleeding of gums or family history of bleeding problems a bleeding disorder can be present. Blood tests, physical exam, ultrasound are usually done.
In some cases a hysteroscopy is needed. This is the inspection of the uterus with a fiberoptic instrument. Endometrial polyps, fibroids, endometritis or adenomyosis could be detected. Iron supplements are important. Once the cause of the heavy periods is determined, the treatment can be individualized. Monitoring of the results is helpful.