Diagnosis of Periods, heavy

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Diagnosing the cause of heavy periods involves a careful general medical history to explore possible background causes, and physical examination including a vaginal examination to check for polyps and womb enlargement.

You might be asked to fill in a chart showing pictures of how heavy your bleeding is, or to describe how often you need to change your sanitary protection (towels and tampons).

Blood tests can help detect anaemia, which can be caused by prolonged heavy periods, thyroid problems, and menopause. Blood tests are usually only done if the diagnosis is not obvious.

Ultrasound examination of the womb is very helpful in detecting fibroids, polyps inside the womb, and some forms of cancer. This is usually done as a transvaginal scan, when a small scanner is inserted into the vagina, to take a close-up scan of the womb.

If no obvious GP-treatable cause is found that can be treated by a GP, referral to a gynaecologist for further investigations is usual. This usually involves taking a small sample (biopsy) of the womb lining, for examination under a microscope.

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