Heavy periods are common, but when does heavy menstrual bleeding become something worth investigating? And why do so many women spend years living with abnormal bleeding, iron deficiency and changes to their quality of life before seeking help?
In this episode of Fiercely Well, I’m joined by Associate Professor Talat Uppal, obstetrician and gynaecologist, Director of Women’s Health Road and founder of Bleed Better, for an honest conversation about heavy menstrual bleeding and why understanding what is normal, and what may not be, is important.
Talat shares that women can wait several years, and sometimes even a decade, before seeking care for heavy periods. There are many reasons for this. Periods are still surrounded by shame and stigma, access to care can be difficult, and women are very good at finding ways to keep going. Sometimes heavy bleeding simply becomes something we learn to accommodate rather than something we realise we can ask for help with.
We unpack what abnormal uterine bleeding actually means and some of the signs that heavy periods may be affecting your health and quality of life. That might mean changing menstrual products through the night, passing large clots, bleeding through clothing, using multiple products at once, feeling exhausted, or finding yourself changing what you do because of your period.
Importantly, this conversation is about menstrual literacy and giving women the information to recognise what is happening in their bodies and understand that there may be options available.
We talk about treatment for heavy periods, including hormonal and non-hormonal options, and why care does not have to be one-size-fits-all. I particularly loved Talat’s approach to having a Plan A and a Plan B. If one treatment does not suit you, the conversation does not have to end there. There can be another option to explore together.
We also spend time talking about iron deficiency in women, particularly when it occurs alongside heavy menstrual bleeding. Talat explains that two-thirds of women with heavy bleeding are iron deficient, and we explore why iron deficiency can become so normalised within families that it starts to feel almost inevitable.
This leads us into a fascinating conversation about the patterns Talat sees across mothers, daughters and even grandmothers, as well as why identifying and treating iron deficiency can matter before and during pregnancy. We also discuss heavy bleeding at different stages of life, from adolescence through the reproductive years and into perimenopause.
In this episode, we explore:
What heavy menstrual bleeding and abnormal uterine bleeding actually mean
The signs that your heavy periods may be affecting your quality of life
Why women can wait years before seeking help for heavy bleeding
The relationship between heavy periods and iron deficiency
Hormonal and non-hormonal treatment options for heavy periods
Why having a Plan A, Plan B and sometimes Plan C can make treatment feel more manageable
Why a normal pelvic ultrasound does not necessarily mean heavy bleeding should be ignored
Family and generational patterns in heavy menstrual bleeding and iron deficiency
Heavy bleeding during adolescence, the reproductive years and perimenopause
Why menstrual health and menstrual literacy deserve more attention
Why endometrial cancer is one important diagnosis clinicians do not want to miss.
Towards the end of our conversation, Talat leaves us with a message that really resonated with me:
“Please, please, please do not accept a substandard quality of life.”
I think that is such an important place to leave this conversation.
If your periods have always been heavy, it can be very easy to assume that this is simply what is normal for you. But something being familiar does not necessarily mean it is something you have to keep putting up with.
Sometimes greater confidence in our health starts with understanding what we are experiencing, knowing the questions we can ask and realising there may be more than one pathway forward.
About A/Prof Talat Uppal
A/Prof Talat Uppal is an obstetrician and gynaecologist and Director of Women’s Health Road, a multidisciplinary women’s health practice in Sydney that runs Australia’s first dedicated abnormal uterine bleeding (AUB) hub, bringing iron infusions, pelvic ultrasound and comprehensive AUB management together under one roof.
Talat is a Clinical Associate Professor at Macquarie University and a Visiting Medical Officer at Macquarie University Hospital and Hornsby Ku-ring-gai Hospital. She also sits on the FIGO Menstrual Disorders Committee and leads Bleed Better, an initiative focused on improving awareness, diagnosis and management of heavy menstrual bleeding and iron deficiency.
She has a special interest in the hysteroscopic management of abnormal uterine bleeding and is leading the development of an interoperable heavy menstrual bleeding pathway incorporating AI.
At the heart of Talat’s work is something that sits beautifully alongside the philosophy of Fiercely Well: improving menstrual literacy, breaking the taboos that still surround periods, and making sure women are not simply left to normalise symptoms that are affecting their quality of life.
Listen to Episode 1 of Fiercely Well with A/Prof Talat Uppal for a thoughtful conversation about heavy periods, iron deficiency, treatment options and understanding your menstrual health.
References:
Website: womenshealthroad.com.au
LinkedIn: linkedin.com/in/dr-talat-uppal
Instagram: @womenshealthroad (Women's Health Road), @bleedbetter (Bleed Better)
TikTok: @womenshealthrd (Women's Health Road)