Abnormal uterine bleeding — periods that are very heavy, prolonged or irregular, bleeding between periods, or any bleeding after menopause — is common and almost always treatable. The first step is to find the cause, which is usually straightforward.
What counts as abnormal?
Bleeding may be abnormal if periods are very heavy (changing protection frequently or passing clots), last longer than a week, come irregularly, occur between periods, or happen after menopause. Our heavy periods clinic assesses these symptoms.
Common causes
- Hormonal changes (including around the perimenopause and with PCOS)
- Fibroids
- Polyps in the womb lining
- Thickening of the womb lining
- Less commonly, pre-cancerous or cancerous changes — which is why post-menopausal bleeding is always assessed
How it is investigated
Assessment usually includes an examination, an ultrasound scan, and sometimes hysteroscopy to look inside the womb and take a sample if needed. This identifies the cause quickly and guides treatment.
Treatment options
- Medication — hormonal and non-hormonal options to reduce bleeding.
- Office or minor procedures — such as removing polyps.
- Surgery — for fibroids or, in selected cases, a hysterectomy when other treatments have not worked.
When to seek help urgently
Any bleeding after the menopause should be checked promptly — see our post-menopausal bleeding clinic. Most causes are benign, but early assessment is important.
See the full hormonal health guide and our price list.
Sources: NICE heavy menstrual bleeding guideline, RCOG, ACOG. This article is for general education and does not replace a medical consultation. Reviewed by Assist. Prof. Dr. Muzaffer Uçarer (Obstetrics & Gynaecology), UCARER Women’s Health, Istanbul.
