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Complete Guide to Heavy Periods & Iron Deficiency

1 in 4 people with a uterus experience heavy periods. Heavy periods (or Heavy Menstrual Bleeding) refers to abnormally heavy or longer than normal periods. Heavy menstrual bleeding can lead to Iron Deficiency Anemia in some people. Both of these conditions can negatively affect a person’s physical, emotional and social well-being.

We are pleased to provide resources below that were created by medical experts. Below, you’ll find information on the treatments for Heavy Menstrual Bleeding and Iron Deficiency Anemia.

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Heavy periods
Investigations and treatment heavy periods
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treating iron

What Is Heavy Menstrual Bleeding?

Heavy Menstrual Bleeding (HMB) refers to abnormally heavy or longer than normal periods. It can lead to significant disruptions in people’s daily activities and lifestyle, impacting their physical, emotional and social well-being.

People with heavy periods may also suffer from Iron Deficiency Anemia, with symptoms such as fatigue, dizziness or shortness of breath.

Learn more about Iron Deficiency here.

heavy bleeding

Heavy Period Symptoms

Do any of these symptoms apply to you? If so, you may suffer from Heavy Menstrual Bleeding.

Illustration of a woman lying awake in bed indicating trouble sleeping thinking about her heavy period.

Having to change sanitary protection during the night

Illustration of a woman with a puff of air coming from mouth indicating shortness of breath.

Feeling faint or breathless during a period

Illustration of a calendar with blood drops marking the days of a period.

Organizing social activities or clothing around bleeding

Illustration of a calendar with blood drops marking the days of a period.
Excessively long, frequent, and/or unpredictable periods
Illustration of a toilet with blood drops coming into it.
Passing large blood clots
Illustration of a woman's pelvis with athletic cloths on with blood stain indicating a leaking period.
Worrying about having bleeding-related accidents
Illustration of a bloody menstrual pads with a clock.
Changing sanitary protection more than once every 2 hours

Diagnosing Heavy Periods

Your doctor may suggest some of these tests to identify the reason for the heavy bleeding, and to detect anemia.
Illustrations of procedures used for diagnosing heavy periods including Sonohysterogram, Endometrial biopsy, Hysteroscopy and Pap test.

Medical Treatment Options

Illustration of a jar of medication with loose pills around.

Non-Steriodal Anti-Inflammatory

Illustration of two jars of medication with loose pills around.

Transexamic Acid

Levonorgestrel IUD

progestins bubble letters
Illustration of a packet of birth control pills.

Combined Hormonal Contraceptive

Illustration of a packet of birth control pills.

Progestin (Cyclic Oral)

Illustration of an unlabelled medication bottle and syringe representing intravenous progestin.

Progestin (Injectable)

GnRH Agonists

GnRH Antagonists (Access handout here)

GnRH Antagonist Combination Therapy

What Is Iron Deficiency?

Iron is an important component of hemoglobin, a protein in red blood cells that transports oxygen around the body.

When your body does not have enough iron, your hemoglobin levels can drop below normal, and your organs are unable to get the right amount of oxygen they require. This condition is known as Iron Deficiency Anemia.

It is the most common form of anemia. Iron Deficiency can lead to many symptoms and impair your ability to do normal daily activities.

2 in 3

Iron Deficiency Anemia Symptoms

If any of the following symptoms apply to you, you may have Iron Deficiency or Iron Deficiency Anemia.

Illustration of a woman with a low battery icon indicating fatigue.
Fatigue, weakness
Illustration of a woman sweating and clutching chest indicating shortness of breath.
Shortness of breath
Illustration of a woman lying awake in bed indicating trouble sleeping.
Difficulty sleeping
Illustration of a legs with squiggles around them indicating restless leg syndrome.
Restless leg
Illustration of a woman with halos around her head indicating dizziness.
Dizziness, fainting
Illustration of a woman with squiggles around her indicating chilliness.
Feeling cold
Illustration of a woman clutching her chest and an icon of a heart indicating heart issues.
Rapid heartbeat
Illustration of a woman with lightening bolts around her head indicating headache.
Headaches
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Conditions for Diagnosis

Medical Treatment Options

Oral Iron

Intravenous Iron

Preparing for Surgery

It is ideal for people to go into surgery with a hemoglobin level

greater than 120 g/L.

If You Are Preparing for Surgery

Importance of Treating Anemia

Frequently Asked Questions About Heavy Periods & Iron Deficiency Anemia

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This material is intended for use by Canadian residents only, and is solely for informational and educational purposes. The information presented is not to be used as a substitute for medical advice, independent judgement, or proper clinical assessment by a physician. The context of each case and individual needs differ between patients and this material cannot be applied without consultation with a trained doctor. This material reflects the information available at the time of preparation.

Homepage graphics created by A. Workewych (Temerty Faculty of Medicine, University of Toronto)