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Q. What is heavy menstrual bleeding?

Answered by
Dr. Sonal Prasad
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 17, 2016 and last reviewed on: Aug 21, 2020

Hello doctor,

Recently, I was diagnosed to have iron deficiency anemia. My primary doctor thinks this is due to heavy menstrual bleeding. Therefore, he advised me to see the gynecologist. I never thought I had heavy periods. What is the actual definition of heavy menstrual bleeding? My period always last for seven 7 days and the first 2 or 3 days will be heavier with some clots. I have to get up during the night once to change the pad only in the first two nights. I usually use about 25 to 30 pads during my periods. Can this be considered as heavy bleeding? For me, this is normal. I have always been this way. My laboratory report showed hemoglobin 8.5, hematocrit 29.7, MCV 66, MCH 19, MCHC 28.6, RDW 18.9, UIBC 430, serum iron 15 and iron saturation and ferritin 3. In addition, I am not sexually active and I am still a virgin. I have never been to the gynecologist and really do not know what to expect. What kind of examination the doctor will perform? How should I prepare for the visit? Please visit.

Dr. Sonal Prasad

Childbirth Educator Lactation Counselor Obstetrics And Gynaecology


Welcome to

  • Yes, your menstruation will be considered as heavy. More than 80 mL of blood loss, bleeding for more than six days and passage of clots indicates heavy flow.
  • Do not be scared about visiting a gynecologist. Since you are a virgin, you will not undergo internal or per speculum examination.
  • You need to undergo ultrasound pelvis along with blood tests that include serum TSH (thyroid-stimulating hormone) and PRL (prolactin levels).
  • I suggest tablet Tranexamic acid 500 mg three times a day during periods of heavy bleeding and Iron supplements 200 mg daily. Consult your specialist doctor, discuss with him or her and take the medicine with consent.

Investigations to be done:

1. Serum TSH and PRL.
2. Ultrasound lower abdomen.

Probable diagnosis:

Menorrhagia with anemia.

Treatment plan:

Tranexamic acid with Iron supplements.

Regarding follow up:

Revert back with the reports to an obstetrician and gynaecologist online.--->

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