Dr Sam Holford demonstrating the Mirena IUS with a model

Abnormal Uterine Bleeding

Bleeding that’s too heavy, too frequent, unpredictable, or happens at unexpected times can be disruptive, exhausting, and isolating. Whether you’ve had heavy periods since your teens or something new has cropped up in your 40s, there’s always a reason — and almost always something we can do about it.

What counts as “abnormal”?

If any of the following sound familiar, your bleeding may be considered abnormal:

  • Soaking through pads, tampons, cups, or discs in less than 2 hours
  • Needing to use double protection (e.g. tampon and pad)
  • Passing large clots
  • Bleeding longer than 8 days
  • Bleeding between periods
  • Spotting after sex
  • Bleeding after menopause

Possible causes

Abnormal bleeding can result from a wide range of causes, including:

  • Hormonal imbalances
  • Fibroids or polyps
  • Endometriosis
  • Adenomyosis
  • Bleeding disorders
  • Thyroid issues
  • Endometrial hyperplasia or cancer (less common, but important to exclude)

Every situation is different, and figuring out your cause is the first step toward getting you feeling better.

What I offer

I take a step-by-step approach to find out what’s going on and what will help:

  • Detailed history and consultation
  • Transvaginal ultrasound (done during your visit)
  • Endometrial biopsy, if appropriate
  • Blood tests, including hormones and iron levels
  • MRI (for complex cases)

Once we have a diagnosis, we’ll talk through medical options (like progestins, IUDs, or tranexamic acid), as well as minimally invasive surgery when needed.

Dr Sam Holford

Compassionate care

You don’t need to just “put up with it.” There’s no badge of honour for suffering through heavy bleeding, especially when safe and effective treatments are available.

Book an appointment

FAQs

What is abnormal uterine bleeding?
Abnormal uterine bleeding can include soaking through pads or tampons in less than 2 hours, needing double protection, passing large clots, bleeding for more than 8 days, bleeding between periods, spotting after sex, bleeding that interferes with work or activity, or any bleeding after menopause.
What causes abnormal uterine bleeding?
There are many possible causes, including hormonal imbalances, fibroids or polyps, endometriosis and adenomyosis, bleeding disorders, thyroid issues, and, less commonly, endometrial hyperplasia or cancer.
How is the cause of abnormal bleeding investigated?
I take a detailed history, perform a transvaginal ultrasound, and may recommend an endometrial biopsy, blood tests to check hormones and iron levels, or an MRI for some cases.
What treatments are available for abnormal uterine bleeding?
Treatment options depend on the diagnosis and can include medical options like progestins, IUDs, or tranexamic acid, as well as minimally invasive surgery when necessary.

Useful resources

Please note: This information is general in nature and not a substitute for medical advice tailored to your specific situation.