What to Do About Menstrual Flooding: Causes of Heavy Periods | Warning Signs of Sudden Heavy Flow | Diet and Screening Recommendations

What Is Heavy Menstrual Bleeding? Understanding Normal Period Flow

In general, a normal menstrual cycle lasts between 21 to 35 days, with each period lasting 3 to 7 days and a total blood loss of approximately 20 to 80 millilitres. You may be experiencing menorrhagia (heavy menstrual bleeding) if you notice any of the following:

• Your period lasts longer than 7 days
• You need to change your pad or tampon every 1 to 2 hours
• You pass large blood clots during your period
• Your menstrual flow is noticeably heavier than usual

Heavy periods are more than just "bleeding a lot" — they may indicate an underlying hormonal imbalance or uterine condition that should not be ignored based on observation alone.

How Common Is Heavy Menstrual Bleeding Among Women in Hong Kong?

While many women tend to dismiss changes in their menstrual cycle as normal, heavy menstrual bleeding is actually quite prevalent. Studies show that approximately 20 to 30 percent of women will experience menorrhagia at some point in their lives. In Hong Kong, this issue is particularly likely to go unnoticed due to factors such as:

• High levels of work-related stress, which can disrupt hormonal balance
• Irregular sleep schedules (frequent late nights)
• Delayed childbearing or nulliparity (never having given birth)
• Lack of routine gynaecological check-ups

Many women assume their symptoms are "just stress," but prolonged neglect could mean missing the window for early detection of uterine conditions.

What Causes Heavy Menstrual Bleeding?

Hormonal Imbalance (Most Common) - When oestrogen levels are too high and progesterone is insufficient, the uterine lining (endometrium) can become excessively thickened. This leads to heavier shedding during menstruation, resulting in heavy bleeding. This is commonly seen in:

• Early puberty
• Individuals under significant stress
• The perimenopausal transition

Structural Uterine Abnormalities - The following gynaecological conditions are also common causes of heavy menstrual bleeding:

• Uterine fibroids (most common)
• Endometrial hyperplasia
• Uterine polyps

Perimenopausal Changes - As women approach menopause, ovulation becomes irregular, which can lead to unpredictable periods with fluctuating flow — sometimes heavy, sometimes light.

Other Health Factors - Thyroid disorders, blood clotting abnormalities, hormonal medications or contraceptives, and chronic stress.

What to Do When You Experience Menstrual Flooding: When to Seek Medical Attention

If your menstrual flow suddenly becomes extremely heavy — sometimes described as "flooding" — you should be on high alert. If heavy bleeding persists, the following diagnostic tests are recommended to identify the underlying cause:

• Pelvic Ultrasound - To check for uterine fibroids or endometrial abnormalities
• Blood Tests - To assess for anaemia and evaluate hormone levels
• Endometrial Biopsy - Recommended for individuals at higher risk

Early gynaecological evaluation can help ensure timely treatment and prevent conditions from worsening.

If your bleeding is so heavy that you need to change your sanitary product every hour, if you develop symptoms of anaemia (dizziness, heart palpitations, or weakness), or if you experience severe abdominal pain, you should rest immediately, stay hydrated, avoid strenuous activity, and seek medical attention at a clinic or emergency department as soon as possible. Severe menorrhagia can lead to acute anaemia and should not be left untreated.

What to Eat When Your Period Is Heavy: Dietary Tips for Managing Symptoms

A common question is: "What should I eat if my period is heavy?" The right diet can certainly help manage symptoms.

• Iron-rich foods for blood replenishment: Red meat, pork liver, spinach, black fungus, red dates, and brown sugar
• To boost iron absorption: Vitamin C-rich foods (oranges, kiwi fruit)
• Foods to avoid: Coffee and strong tea, which can inhibit iron absorption; excessively cold or spicy foods

In addition, maintaining a regular sleep schedule and managing stress (through exercise or yoga, for example) can help stabilise hormone levels.

Heavy Menstrual Bleeding: Frequently Asked Questions