Gynaecology
Heavy & Irregular Bleeding
Heavy or unpredictable periods are common, often dismissed, and yet have a profound impact on quality of life. Effective treatments — many of them non-surgical — are available.
Heavy menstrual bleeding (HMB) and irregular bleeding affect approximately one in four women. Beyond the inconvenience, persistent heavy bleeding can lead to iron deficiency anaemia, fatigue, missed work, and significant disruption to daily life and mental wellbeing.
Symptoms
Heavy bleeding is often normalised — but these signs indicate that specialist assessment is worthwhile.
Common causes
Heavy or irregular bleeding has many possible causes — identifying the right one shapes the treatment.
How heavy bleeding is investigated
A thorough clinical history and careful pelvic examination to understand the pattern of bleeding and identify any structural findings.
Full blood count and iron studies to assess for anaemia, plus thyroid function and coagulation tests where indicated.
To assess for fibroids, polyps, adenomyosis and other structural causes of abnormal bleeding within the uterus and ovaries.
Where indicated, a sample of the uterine lining to exclude hyperplasia or other concerning changes — particularly in women over 45 or with risk factors.
Direct visualisation of the uterine cavity using a small camera — the most accurate way to identify polyps, fibroids and other intrauterine pathology.
Treatment options
Treatment is tailored to the underlying cause, your fertility plans and lifestyle — with a preference for the least invasive effective option.
Tranexamic acid & NSAIDs
Non-hormonal medications taken during periods to reduce blood loss without affecting fertility.
Hormonal therapy
Combined oral contraceptive pill or oral progestogens to regulate and lighten periods.
Mirena IUD
Often highly effective and well tolerated — a long-acting, reversible option with minimal systemic effects.
Hysteroscopic surgery
Removal of polyps or submucosal fibroids via the uterine cavity — no external incisions required.
Endometrial ablation
A minimally invasive procedure to reduce or stop periods in women who have completed their family.
Laparoscopic hysterectomy
A definitive option when other treatments have not achieved a satisfactory result or are less desirable and family is complete.
Least invasive, most effective
The right treatment for heavy bleeding depends on the cause, your stage of life, fertility plans and lifestyle. Dr Krones provides a clear, considered explanation of the underlying cause and the realistic options — with a strong preference for the least invasive approach that will achieve a good result.
When to see a specialist
Do not dismiss heavy or irregular bleeding as simply "normal." Specialist review is recommended for:
- Heavy or prolonged periods affecting daily life
- Bleeding between periods
- Bleeding after intercourse
- Any post-menopausal bleeding — always warrants prompt assessment
Book a consultation
Dr Krones consults at Suite 3A, North Shore Private Hospital, St Leonards, with operating privileges at North Shore Private Hospital and The Mater Hospital, Crows Nest.
A valid GP or specialist referral is required for all new appointments.
02 9053 1245