Women’s periods vary widely, but when you experience heavy menstrual bleeding and painful cramps that interfere with your day-to-day activities, it may be a condition doctors term menorrhagia. Menorrhagia is abnormal, but it’s also very common—about one out of five women see a doctor for heavy bleeding each year. If you’ve been wondering if you should call your healthcare provider for heavy menstrual bleeding, here’s some information that can help. What a Heavy Period Means: Common Causes of Heavy Menstrual Bleeding Some of the more common causes of heavy menstrual bleeding are: Hormone imbalance including polycystic ovary syndrome (PCOS) Fibroid tumors Adenomyosis, where tissue from the endometrial lining becomes embedded in the uterus Endometriosis, where tissue from the uterine lining grows outside the uterus IUD use (intrauterine birth control device) Medications including blood thinners Miscarriage or ectopic pregnancy Obesity Young girls may have very heavy menstrual bleeding if their ovaries didn’t release an egg during their cycle. Less common but serious reasons for heavy bleeding may include bleeding disorders, liver or kidney disease, and cancer. Heavy Menstrual Bleeding Treatment at Home You may read or hear about home remedies for heavy bleeding, including taking folic acid supplements, but there is no evidence these remedies work. Track your sanitary pad or tampon use to help your doctor assess how heavy the bleeding is and be aware that heavy menstrual bleeding can lead to anemia, which requires medical treatment. When to See a Doctor for Heavy Menstrual Bleeding Although many women experience a day or two of heavy bleeding during their menstrual cycle, there are signs that it’s time to call your healthcare provider. These include: Changing tampons or sanitary pads about every hour to avoid soaking through Doubling up on sanitary protection to avoid soaking through Getting up during the night to change sanitary protection Bleeding lasts more than a week Passing blood clots larger than a quarter Feeling tired or short of breath If your abnormal vaginal bleeding is persistent or causes you concern, seek prompt medical care. Who to See for Heavy Menstrual Bleeding Contact your gynecologist or primary care doctor to discuss your heavy menstrual bleeding, especially if it is disrupting your daily life. Your doctor may be able to treat you with medication. Depending on the underlying cause, you may need a referral to another specialist, such as an endocrinologist for PCOS treatment. A specialist who routinely treats women with heavy periods is the best choice. This provider can advise you about the best available treatment options.