Periwell
← Back to Clinical Directory
Category: CycleClinical Profile

Heavy Bleeding

Massive, unpredictable menstrual bleeding that can cause anemia and absolute terror.

Biological Mechanism

In early perimenopause, frequent anovulatory cycles occur. Without ovulation, there is no progesterone to halt the estrogen-driven thickening of the uterine lining. The lining builds up excessively and eventually sheds in a chaotic, massive 'flooding' event.

Common Misdiagnoses

Endometrial cancer (must always be ruled out), Fibroids (often worsen in early perimenopause)

Evidence-Based Treatments

  • 01Mirena IUD (Levonorgestrel)

    The absolute gold standard. Locally thins the lining, controlling the bleeding.

  • 02Tranexamic Acid

    A non-hormonal medication taken only during bleeding to promote clotting.