What Actually Counts as Heavy Bleeding?

Before we dive in, let’s get clear on what “heavy” actually means, because many of us have normalised our periods to the point where we don’t even realise they’re unusually heavy.

Medically, heavy menstrual bleeding (also called menorrhagia) is defined as losing more than 80 mL of blood per cycle – but let’s be honest, no one’s measuring that at home.

Here’s what heavy bleeding typically looks like in real life:

• Soaking through a pad or tampon every two hours or less
• Needing to change pads overnight
• Passing blood clots larger than a 50-cent piece
• Bleeding for longer than seven days
• Feeling tired, dizzy, or short of breath during or after your period
• Needing to take time off work, school, or social activities because of your period

If any of this sounds familiar, you’re not alone – and you’re definitely not overreacting. These symptoms deserve attention.

Can You Get Pregnant with Heavy Periods?

The short answer is yes. Heavy periods don’t automatically mean you can’t conceive.

However, heavy bleeding can signal underlying issues that may affect fertility, or it can lead to nutrient deficiencies that make conception more challenging. The key word here is may – not will. Many women with heavy periods go on to have healthy pregnancies.

What matters most is understanding what’s causing the heavy bleeding and addressing it appropriately.

Why Heavy Periods Matter for Fertility

Heavy menstrual bleeding can impact your fertility and overall reproductive health in a few different ways:

1. Iron Deficiency and Anaemia

This is one of the most common consequences of heavy periods, and it’s something I see regularly in clinic.

When you’re losing significant amounts of blood each month, your body’s iron stores become depleted. Iron is essential for making haemoglobin – the protein in red blood cells that carries oxygen throughout your body. Without adequate iron, you can develop iron deficiency anaemia.

Why does this matter for fertility?

Research shows that iron deficiency can disrupt your menstrual cycle, potentially leading to irregular ovulation or even absent periods (amenorrhea). Studies in animals have demonstrated that iron restriction decreases ovarian function, follicle development, and fertility.

For women who do become pregnant while iron-deficient, the consequences can be more serious. Iron deficiency during pregnancy is associated with adverse outcomes for both mother and baby, including impaired foetal neurodevelopment – effects that can persist into childhood and beyond.

Common signs of iron deficiency include:

• Persistent fatigue and weakness
• Pale skin
• Shortness of breath
• Dizziness or light-headedness
• Cold hands and feet
• Brittle nails
• Difficulty concentrating

If you’re experiencing heavy periods alongside any of these symptoms, it’s worth having your iron levels checked through a simple blood test.

2. Other Nutrient Deficiencies

While iron gets most of the attention (and rightfully so), heavy bleeding can also deplete other important nutrients involved in fertility and overall health, including:

• Folate (Vitamin B9): Essential for DNA synthesis, cell division, and preventing neural tube defects in early pregnancy
• Vitamin B12: Crucial for red blood cell formation, neurological function, and fertility
• Vitamin C: Supports iron absorption and immune function
• Zinc: Important for hormone production and egg quality

These depletions can happen gradually and quietly, which is why heavy periods need proper investigation and support.

3. Underlying Conditions

Heavy periods are often a symptom of an underlying gynaecological condition that can also affect fertility. Let’s look at the most common culprits:

Uterine Fibroids (Leiomyomas)

These are non-cancerous growths in or around the uterus. Up to 80% of women develop fibroids by age 50, though many never have symptoms. When fibroids do cause problems, heavy bleeding is one of the most common complaints.

Fibroids can impact fertility depending on their size and location. Submucosal fibroids (those growing into the uterine cavity) can interfere with implantation or increase the risk of miscarriage.

Endometriosis

This condition occurs when tissue similar to the uterine lining grows outside the uterus – typically on the ovaries, fallopian tubes, or pelvic cavity. While endometriosis is more commonly associated with pelvic pain than heavy bleeding, it can cause both.

Endometriosis affects approximately 10% of reproductive-aged women and is one of the leading causes of female infertility. It can impact fertility through multiple mechanisms, including inflammation, scarring, and interference with egg quality and implantation.

Adenomyosis

Think of this as endometriosis’s cousin. With adenomyosis, endometrial-like tissue grows into the muscular wall of the uterus itself, causing the uterus to enlarge and become tender. Heavy, prolonged, painful periods are hallmark symptoms.

Adenomyosis can affect fertility, though the research is still evolving. It’s also more common than previously thought and can co-exist with endometriosis.

Polycystic Ovary Syndrome (PCOS)

While PCOS is more commonly associated with irregular or absent periods due to lack of ovulation, some women with PCOS experience heavy bleeding when they do menstruate. This happens because infrequent ovulation can lead to a build-up of the uterine lining, which then sheds heavily.

PCOS is one of the most common causes of female infertility, affecting 6-15% of women of reproductive age.

Thyroid Disorders

Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can cause menstrual irregularities, including heavy bleeding. Thyroid hormones play a crucial role in regulating your menstrual cycle and ovulation, so thyroid dysfunction can impact fertility.

Bleeding Disorders

Some women have underlying bleeding disorders like von Willebrand disease, which affects blood clotting. These disorders can cause heavy menstrual bleeding and should be ruled out, especially in younger women who have had heavy periods since their very first cycle.

The Good News

Here’s what I want you to take away from all of this: Most causes of heavy periods can be investigated, diagnosed, and supported.

You don’t have to just “put up with” heavy bleeding. You don’t have to accept fatigue and anaemia as your normal. And with the right support and treatment, many women with heavy periods go on to conceive and have healthy pregnancies.

What You Can Do Right Now

If you’re experiencing heavy periods and are concerned about your fertility, here are some practical steps:

1. Track Your Symptoms

Keep a record of your menstrual cycle, including:

• How many days you bleed
• How heavy the bleeding is (number of pads/tampons used per day)
• Any clots you pass
• Associated symptoms (pain, fatigue, dizziness)

This information is incredibly valuable when working with a healthcare practitioner to investigate the cause.

2. Get the Right Testing

At a minimum, you should have:

• Full blood count (FBC) to check for anaemia
• Ferritin levels to assess your iron stores (aim for at least 30 ng/mL, ideally 50-100 ng/mL for optimal fertility)
• Thyroid function tests (TSH, free T4, free T3)
• Depending on your symptoms and history, you may also need pelvic ultrasound, hormone testing, or other investigations

3. Support Your Iron and Nutrient Status

While you’re investigating the cause of your heavy periods, you can start supporting your body nutritionally:

• Increase iron-rich foods: Red meat, chicken, fish, lentils, beans, tofu, spinach, and iron-fortified cereals
• Pair iron with vitamin C: This enhances absorption – think lemon juice on your salad, berries with your breakfast
• Consider supplementation: Work with a practitioner to determine the right type and dose of iron for you (there are many forms, and some are much better absorbed than others)
• Don’t forget other nutrients: A good-quality prenatal or multivitamin can help cover your bases for folate, B12, and other fertility-supporting nutrients

4. Address the Root Cause

This is where working with a fertility naturopath can make a real difference. Rather than just treating the symptom (heavy bleeding), we work to identify and address the underlying cause.

Treatment might include:

• Nutrition and lifestyle modifications tailored to your specific condition
• Herbal medicine to help regulate your cycle and reduce bleeding
• Targeted supplementation to address deficiencies and support hormonal balance
• Stress management strategies (stress can worsen many gynaecological conditions)
• Coordination with your GP or specialist for medical or surgical interventions if needed

You Don’t Have to Navigate This Alone

Heavy periods can feel overwhelming, especially when you’re trying to conceive or thinking about your fertility. But you don’t have to figure this out by yourself.

The beautiful thing about addressing heavy periods is that when we support your body properly, we’re not just improving your fertility – we’re improving your energy, your quality of life, and your overall wellbeing.

You deserve to feel good in your body. You deserve periods that don’t disrupt your life. And you deserve personalised support that addresses your unique situation.

If heavy periods are impacting your cycles or fertility, I’d love to support you.

Book a consultation with me here to explore your options and create a personalised plan that addresses the root cause of your heavy bleeding and supports your reproductive health.

Because you deserve answers, support, and a path forward that actually works for your body.

Georgia x

P.S. If you found this helpful, save it or share it with someone who might need to hear this message. Heavy periods are common, but they’re not something you have to suffer through – and they don’t have to stand in the way of your fertility goals.