Patient Education · Balaji Horizon
Heavy Menstrual Bleeding (HMB)
Reviewed by Dr. Priyadatt PatelSenior Gynecologist · Advanced Laparoscopic Surgeon · IVF & Endometriosis Programme Lead
DPP
Reviewed by Dr. Priyadatt PatelSenior Gynecologist · Advanced Laparoscopic Surgeon · Last reviewed 26 Sep 2026

About the Author
Dr. Priyadatt Patel
Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF &
Endometriosis Programme Lead
Co-founder of Balaji Horizon Women’s Hospital. ESHRE / ASRM / FIGO-aligned practice. ★ 5.0 on Google · 250+ reviews.
View full profileBook consultationRelated procedure at Balaji Horizon: Hysteroscopy — a keyhole way to look inside the womb and treat polyps or submucosal fibroids that can cause heavy bleeding.
Related: Advised to have your uterus removed? See Do you really need a hysterectomy? A second opinion — and the uterus-sparing alternatives.
Frequently Asked Questions
What counts as heavy menstrual bleeding?
Bleeding heavy enough to soak through pads/tampons every 1–2 hours, pass large clots, extend beyond 7 days, or cause iron deficiency. Self-report of significant impact is valid.
Is HMB serious?
It significantly affects quality of life and causes iron deficiency. Less commonly, HMB signals significant pathology (large fibroids, adenomyosis, hyperplasia or rarely cancer). It deserves proper evaluation.
Will medical treatment work?
For most causes, yes. Tranexamic acid, NSAIDs, hormonal options and Mirena IUS produce substantial improvement in most women. Medical treatment should be tried adequately before surgery is considered.
Is Mirena IUS suitable for me?
Mirena is suitable for most women with HMB, including those with fibroids (if cavity is not significantly distorted) and adenomyosis. It also provides contraception and is reversible.
Will I need a hysterectomy?
Not usually. Hysterectomy is one option for women with persistent HMB who have completed their family and failed medical treatment, but most women avoid it with appropriate medical or less invasive surgical options.
Can I get pregnant with HMB?
Yes, depending on the cause. Treat the underlying cause; ovulatory function is usually preserved. Some treatments (Mirena, COCP) prevent conception during use; tranexamic acid and NSAIDs do not.
Should I see a doctor about heavy periods?
Yes — especially if periods affect work, school, sleep or daily life, or if you have signs of iron deficiency. HMB is not "normal" and deserves evaluation.
Is HMB a sign of cancer?
Most HMB is benign. Endometrial cancer is a rare cause and should be excluded in women over 45 or those with risk factors (obesity, PCOS, unopposed oestrogen exposure, family history).
What is the full form of HMB in gynaecology?
HMB is the abbreviation for heavy menstrual bleeding. It is used in clinic notes, referral letters and ultrasound reports to describe periods that are heavy enough to affect a woman’s daily life — not a separate diagnosis in itself, but the symptom that the PALM-COEIN assessment below is designed to explain.
ISO 9001 CEA Registered ICMR ART (L2) ESHRE ASRM ISUOG