Periods: Heavy period causes concern

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For six to nine months, my periods have been much heavier. They still appear every 28-30 days, lasting about four days, but the amount of blood has increased and there is the occasional small, dark clot. My GP says it's my age, 42. I've been told to take tranexamic acid tablets, which may have improved things a little. I don't get pain, and once the period is over I'm back to normal. A smear test was normal. My GP said my uterus felt a bit bigger than normal, which she put down to age. Am I worrying unnecessarily, or do I need to look into this?

Dr Fred Kavalier answers your health question:

A "normal" period lasts three to five days, with blood loss of 30-50ml (two or three tablespoons). Many women will have heavier blood loss than this, particularly as they get older and nearer the menopause, without any serious cause behind it. But there is a fairly long list of problems that can cause heavy bleeding, and some are potentially serious. I think it is important to find out if there is anything underlying your increasing blood loss. If your uterus is larger than normal, you may have fibroids non-cancerous overgrowths of muscle in the uterus wall. Polyps inside the uterus can also cause excessive bleeding. At the serious end of the spectrum, cancer of the uterus is unlikely. Cervical cancer has been ruled out by a normal smear test. I'd ask your doctor about a scan of the uterus to look for fibroids. If this is normal, see a gynaecologist, who can arrange to look inside the uterus. Heavy bleeding that lasts for months can also make you anaemic.

Please mail your questions for Dr Fred to health@independent.co.uk. He regrets that he is unable to respond personally to questions.