Heavy periods

Heavy and painful periods in Miami.

Heavy bleeding is not something to put up with until menopause, and the workup for it is short.

The options

How this is approached here

  1. 01

    Bloods to check for anaemia and thyroid

    Because both are common and both are fixable.

  2. 02

    Ultrasound to look for fibroids

    Polyps and adenomyosis.

  3. 03

    Hysteroscopy where the scan is unclear

    Or a polyp is suspected.

  4. 04

    Medical management first

    Tranexamic acid, hormonal options, or a levonorgestrel IUD.

  5. 05

    Endometrial ablation or surgery where medical

    Treatment has not worked and childbearing is complete.

What counts as heavy

If any of these is true, it is worth investigating

Changing protection every hour or two

For several hours running.

Needing double protection

Or waking at night to change.

Passing clots larger than a coin

Bleeding for more than seven days

Planning work

Travel or exercise around your period.

Being told you are anaemic

Or feeling breathless on stairs you used to manage.

The workup

Short, and mostly done in one visit

  1. 01

    Full blood count and ferritin

    Because iron deficiency is both the consequence and a treatable cause of fatigue.

  2. 02

    Thyroid function and where the history suggests it, clotting studies — bleeding disorders are under-diagnosed in women and often present exactly this way.

  3. 03

    Pelvic ultrasound for fibroids

    Polyps and adenomyosis.

  4. 04

    Endometrial biopsy where you are over forty-five

    Or younger with risk factors or irregular bleeding. It is done in the office and takes a few minutes.

  5. 05

    Hysteroscopy where the scan is equivocal

    Or a polyp is suspected.

Treatment ladder

Medical first, almost always

  1. 01

    Tranexamic acid taken only during bleeding

    Not hormonal, and it reduces blood loss substantially for many people.

  2. 02

    A levonorgestrel intrauterine system

    Which is first-line medical treatment for heavy bleeding and not only a contraceptive.

  3. 03

    Combined hormonal contraception or cyclical progestogen

    Where the IUD is not wanted.

  4. 04

    Endometrial ablation where medical treatment has failed and childbearing is complete.

  5. 05

    Surgery for the underlying cause

    Polypectomy, myomectomy or hysterectomy — where there is one to treat.

Heavy periods: common questions

How heavy is too heavy?
If you are changing protection hourly, passing clots larger than a coin, bleeding through at night, or planning your life around your period, that is worth investigating.
Will I need a biopsy?
Sometimes, particularly over forty-five or with irregular bleeding. It is done in the office and takes a few minutes.
Is an IUD really a treatment for this?
Yes — a levonorgestrel IUD is first-line medical treatment for heavy menstrual bleeding, not only contraception.
Will the IUD make the bleeding worse?
Irregular spotting for the first three to six months is common and then it usually settles, often to very light periods or none. The first three months are not the result.
Do I have to try medication before surgery?
Not as a rule imposed on you, but medical treatment is less invasive and works for most people, so it is where we start unless there is a reason not to.
Is heavy bleeding ever an emergency?
Soaking through protection every hour for several hours, feeling faint, or breathlessness at rest warrants urgent assessment the same day.

Know before you book.

Vireo opens in 2027. Until then the plan list, panel status and first-available wait for every office are published on this site and kept current. Questions can go to the practice office on (305) 555-0180.

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