The short explanation
It is worth getting checked rather than accepting it. Periods often change in the forties as hormone levels start to shift towards menopause, and heavier bleeding is common in these years. But common does not mean it should simply be put up with, and a change from your usual pattern deserves a proper look. Needing double protection at night and still leaking through is one of the signs doctors use to describe heavy menstrual bleeding. Causes in this age group include hormonal changes, fibroids, adenomyosis, polyps in the womb lining, thyroid problems and, less often, changes in the womb lining that need to be ruled out. Most causes are treatable, and there are options that range from medicines to procedures.
What depends on your situation
The parts of this that change from woman to woman. Uncertainty is stated, not hidden.
- A doctor will usually want to know how long the change has been going on, how many days the bleeding lasts, whether there is bleeding between periods or after sex, and whether you feel tired or breathless. Bleeding between periods and bleeding after sex are reasons to be seen sooner.
- Blood tests for anaemia are often checked, because heavy periods over months can lower iron levels slowly without you noticing. A pelvic ultrasound is commonly suggested, and sometimes a sample of the womb lining is taken, which is a short outpatient procedure.
- Government hospitals with a gynaecology department can do these tests at low cost. You can ask to be seen by a woman doctor and bring someone with you.
What this answer cannot determine
The boundary of online education. These need a clinician who can see you.
- This answer cannot tell you why your bleeding has changed. Only an examination, a scan and blood tests can show whether the cause is hormonal, structural or something else that needs treatment.
Questions for your clinician
Take these with you. You can add any of them to an appointment card.
- Is my bleeding heavy enough to cause anaemia, and can you check my blood count?
- Do I need an ultrasound, and would a sample of the womb lining be useful at my age?
- What treatment options are there if this is linked to approaching menopause?
- Which changes in my bleeding should make me come back sooner?
When to seek help
Clinician-approved guidance for this topic. When in doubt, being seen is never the wrong choice.
Emergency — call 112 now
- Call 112 or go to the nearest emergency department if you are soaking through protection every hour for several hours, feel faint or dizzy when you stand, or have chest pain or breathlessness.
Get help the same day
- Get care the same day if you feel very weak, your heart is racing, or the bleeding is much heavier than anything you have had before.
Book an appointment soon
- See a gynaecologist within a few days to a couple of weeks if you have bleeding between periods or after sex along with the heavy periods.
Raise it at a routine appointment
- Book an appointment soon if the heavy bleeding has continued for more than a couple of cycles, even if you otherwise feel well.
Sources
The evidence this explanation is built on.
- Heavy periods NHS
- Fibroids NHS
- Adenomyosis Cleveland Clinic
Who wrote and reviewed this
Every AskHer answer names its author. A clinically reviewed answer also names the clinician who signed it off — if no clinician is named below, it has not been clinically reviewed.
- Author
- AskHer Editorial (AI-assisted draft) AskHer's editorial team — not an individual clinician Works in English, தமிழ், हिन्दी
- Clinical reviewer
- Nobody yet No clinician has signed this answer off, and no person on the editorial team has read it yet. That is what the “Written with AI assistance” label means. It is queued for an editor to read, and then for a clinician who works in this area. The sources it was drafted against are listed above.
- Review status
- Written with AI assistance — not yet reviewed by a person
- Last reviewed
- Not yet reviewed by a person
- Version
- 1
Correction history
Substantive changes are listed, not quietly edited away.
No corrections have been made since this answer was first published.
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