Heavy Periods

Changing pads every hour or two, doubling up, or planning life around flooding? That’s heavy. About 1 in 4 people with periods have it, and good treatments exist.

Signs: changing a pad or tampon every 1–2 hours, needing two products at once, periods lasting more than 7–8 days, clots bigger than a 50 cent coin, bleeding through to clothes or bedding, taking time off, or feeling tired and breathless.

Why it happens: often no cause is found. Causes include fibroids, polyps, adenomyosis, endometriosis, PCOS, an underactive thyroid, perimenopause or the teen years, bleeding disorders such as von Willebrand disease, and blood thinners. Rarely, womb cancer.

Tests: a period diary, a blood count and iron levels, and depending on your story, thyroid tests, an STI test and a pelvic ultrasound.

The heavy period ladder

Of the first-line options, the hormonal IUD cuts bleeding the most; tranexamic acid is the strongest non-hormonal tablet. Check your iron either way.

1. Step 1 · Self-carePeriod diary and iron checkTrack days, products used and flooding. Ask for a blood count and iron levels.

   Works

   Low iron is common with heavy periods and is fixable with tablets or an infusion

   Cost

   Free diary; blood tests usually Medicare-covered

   How long

   A few cycles

   Watch for

   Tiredness, dizziness or breathlessness can mean anaemia. See our iron deficiency sheet.

   Your period app finally earns its keep.

2. Step 2 · PrescriptionTranexamic acidNon-hormonal tablets taken only on heavy days.

   Works

   Cuts blood loss by about 40–50%

   Cost

   Prescription; usually $25 or less on the PBS

   How long

   Only during heavy days

   Watch for

   Not if you’ve had a blood clot. Trials were too small to rule out a small clot risk.

   Works on the bleeding, leaves your hormones alone.

3. Step 3 · PharmacyAnti-inflammatories (naproxen, mefenamic acid)Taken during the period; also ease period pain.

   Works

   Smaller effect: less than tranexamic acid or the hormonal IUD, but a bonus for pain

   Cost

   About $5–15

   How long

   During the period

   Watch for

   Stomach, kidney and asthma cautions.

   A two-for-one: less pain, slightly less blood.

4. Step 4 · PrescriptionHormonal IUD (levonorgestrel)A small device in the womb that releases a progestogen. Also highly effective contraception.

   Works

   The biggest drop in bleeding of the first-line treatments (about 100 mL less a cycle)

   Cost

   PBS-listed device ($25 or less) plus an insertion fee, which varies

   How long

   Lasts years

   Watch for

   Irregular spotting for the first few months is common.

   Fit once, forget it for years.

5. Step 5 · PrescriptionCombined pill or progestogen tabletsHormone tablets that lighten periods and make them predictable.

   Works

   Reduce bleeding; long-cycle progestogens cut about 77 mL a cycle in trials (low certainty)

   Cost

   Many under the $25 PBS co-payment; some brands are private

   How long

   Ongoing

   Watch for

   The combined pill isn’t safe for everyone, such as some people with clot or migraine risks.

   A familiar option that does double duty as contraception.

6. Step 6 · SpecialistGynaecologist: ablation, fibroid surgery or hysterectomyIf tablets and the IUD fail, or fibroids or polyps are the cause.

   Works

   Ablation and hysterectomy reduce bleeding the most; hysterectomy is permanent

   Cost

   Public waiting lists; private fees vary, with Medicare rebates

   How long

   Weeks to recover

   Watch for

   Ablation isn’t suitable if you may want a pregnancy.

   Big guns, for when the small ones miss.

Costs are rough Australian prices in November 2026 and vary by pharmacy and provider. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials, not promises.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

• “Hormone balancing” supplementsNot properly tested for heavy bleeding. Expensive, and they delay treatments that work.
• Diet alone to fix low ironWhen heavy periods have drained your iron, supplements or an infusion are usually needed. Spinach can’t keep up.
• Just putting up with itHeavy periods are common, not compulsory. Effective treatments exist.

What you can do

• Keep a period diary for 2–3 cycles and bring it to your GP.
• Ask for an iron check if you’re tired or breathless.
• Use period-proof underwear or layered products while sorting treatment.
• Read Healthdirect’s heavy periods guide for Australian services.

See your GP if

• Heavy periods are affecting your life
• Bleeding between periods, after sex or after menopause
• Heavy periods with pain when peeing, pooing or having sex
• You feel tired, dizzy or breathless
• Periods are suddenly much heavier than usual

Get urgent care (an urgent care clinic or emergency department, or call 000 (Australia) or your local emergency number. From a mobile, 112 works in most countries.) for heavy bleeding with dizziness, fainting or weakness, or bleeding much heavier than ever before. If you could be pregnant, say so.

Helpful resources

• Healthdirect: Heavy periodsSigns, causes, treatments and Australian services. Free, Australia.
• NHS: Heavy periodsShort guide to what counts as heavy and treatment options. Free, UK.
• Iron deficiency fact sheetSpotting, testing and treating low iron. Free, from us.

Evidence and more information

• Healthdirect: Heavy periods (menorrhagia)
• NHS: Heavy periods
• Cochrane 2022: Which is the best treatment for heavy menstrual bleeding?
• Cochrane: Tranexamic acid for heavy menstrual bleeding
• Cochrane: Anti-inflammatories for heavy menstrual bleeding

Reviewed 1 November 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP, physio or pharmacist.

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