Thursday, January 8, 2026
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When Normal Is Not Normal: Rethinking Heavy Periods And Bleeding Disorders

(By Dr. Shibani Devi)

Heavy menstrual bleeding (HMB) is often normalised as an inevitable element of a woman’s cycle, but rethinking HMB involves comprehending its physiology, identifying potential underlying causes, assessing its impact on everyday living, and pursuing proper medical counsel when necessary.

Menstrual blood loss surpassing 80 ml, soaking through a pad every couple hours, changing a tampon or menstrual cup hourly, passing sizable clots, or bleeding lasting more than 7 days are viewed as warning signs warranting medical focus.

There are instances of HMB are overlooked. Here are scenarios that must not be disregarded: 

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When Bleeding Contributes To Anemia (Low Hemoglobin)

Extended heavy bleeding can deplete iron stores and induce symptoms like fatigue, dizziness, and shortness of breath. Addressing the root source is critical.

Young Girls During Menarche

Guardians often suppose weighty bleeding during a girl’s preliminary cycles is standard. However, certain cases may indicate von Willebrand disease (a coagulation disorder), uterine abnormalities like a two uterus, or underlying systemic issues like long-term kidney disease. Early assessment helps rule out such circumstances.

Delayed Periods Followed By Heavy Bleeding In Young Women

It’s a common misbelief that this is the body’s way of “cleansing.” In actuality, it could be due to extreme hormonal imbalances such as polycystic ovarian syndrome (PCOS) or thyroid dysfunction.

Menstrual Cycles Recurring In Less Than 25 Days

This may point toward hormonal fluctuations or anatomical issues like uterine fibroids, polyps, or even hormone-producing ovarian tumors. Such patterns should be thoroughly investigated.

Heavy Bleeding In Perimenopausal Women

Many women nearing menopause dismiss HMB as part of the transition. However, it could indicate more grave conditions like adenomyosis, uterine tumors, or even endometrial cancer. Timely medical intervention can make a noteworthy difference.

Intermenstrual Bleeding:

Even minor bleeding between periods should not be ignored. It could be a sign of chronic endometritis, cervical polyps, or cesarean scar defects, all of which can affect fertility if left untreated.

Dr Shibani Devi is Consulant – Obstetrics & Gynaecology at Manipal Hospital Bhubaneshwar

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]

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