Heavy menstrual bleeding (HMB), periods that are unusually heavy, prolonged, or disruptive to daily life, affects millions of women around the world. But research consistently shows that women of African origin, both in Africa and in the diaspora (including the UK), are more likely to experience heavy bleeding and related complications.
This article explores why this happens, what the statistics say, and most importantly, what women can do to manage symptoms and get the care they deserve.
Understanding Heavy Menstrual Bleeding
Heavy menstrual bleeding is defined as blood loss greater than 80ml per cycle or periods lasting longer than seven days. In practice, it often means:
● Soaking through pads or tampons every hour for several hours
● Passing large clots
● Needing to use double protection
● Feeling constantly tired or dizzy due to blood loss
If this sounds familiar, you are not alone! And it’s important to know it’s not “something you just have to live with”.
What the Numbers Show
Global Perspective
● Across Africa, studies estimate that 10% to 30% of women experience heavy menstrual bleeding.
● In Northern Tanzania, a 2023 study found that 24.1% of women aged 15–54 reported heavy periods.
● In South Africa, 68.4% of women on blood-thinning medication reported heavy bleeding during one cycle.
● In the United States, Black women report heavier bleeding and more menstrual symptoms during perimenopause than women of other ethnic groups.
● Over 80% of Black women will develop uterine fibroids by age 50, one of the leading causes of heavy periods.
The UK Picture
In the UK:
● Around 20–30% of women experience heavy periods, and 1 in 20 women aged 30-49 visit their GP each year for this issue (NHS).
● Women of African or Caribbean descent are two to three times more likely to develop fibroids than white women, often at a younger age and with more severe symptoms (Royal College of Nursing).
● According to the 2025 “Just a Period” campaign by Wellbeing of Women, the average delay between first symptoms and seeking medical help is 22 months, often due to stigma, embarrassment, or not realising that symptoms are abnormal.
Why Women of African Origin Are More Affected
The reasons are a mix of biological, genetic, social, and healthcare-related factors.
1. Uterine Fibroids: The Leading Cause
Fibroids are benign growths in the uterus and are much more common in women of African origin. They tend to:
● Develop earlier in life
● Grow larger and in greater numbers.
● Cause more severe symptoms like heavy bleeding, painful cramps, and anaemia.
By age 50, more than 8 in 10 Black women have fibroids. In contrast, the figure is closer to 7 in 10 for white women.
2. Genetic and Hormonal Differences
Genetic variations that influence how the uterus responds to hormones like oestrogen and progesterone may make African women more susceptible to fibroid growth and heavy bleeding. Low vitamin D levels, partly because darker skin produces less vitamin D from sunlight, have also been linked to fibroid development.
3. Social and Economic Factors
● Access to care - Women in lower-income areas or those facing language or cultural barriers may delay seeking medical help.
● Diet and nutrition - Iron deficiency and low vitamin D can worsen symptoms and fatigue.
● Comorbidities - Obesity, hypertension, and diabetes, all more prevalent in some African-origin populations, may play a role in hormonal imbalance.
4. Cultural Stigma and Delayed Diagnosis
Across both African countries and the UK, menstrual health remains taboo in many communities. Some women assume heavy bleeding is “just normal” or something they must endure. This leads to delays in diagnosis, meaning fibroids and other causes may worsen before being treated.
How Heavy Bleeding Affects Daily Life
Heavy periods can be exhausting, physically and emotionally. Many women report:
● Feeling drained, dizzy, or anaemic
● Missing work, school, or social events
● Anxiety about leaks or accidents in public
● Strained relationships or reduced intimacy
● Depression or lowered self-esteem
In short: it’s not “just a period.” It’s a serious health issue that deserves attention and treatment.
What Can Help — Diagnosis and Treatment
1. See Your GP Early
If your bleeding affects your quality of life, see your GP. The NHS offers clear diagnostic pathways. You may be provided:
● A pelvic exam
● An ultrasound scan to check for fibroids or other causes
● NICE now recommends hysteroscopy (a small camera inside the womb) earlier for faster, more accurate diagnosis.
2. Treatment Options
Treatment depends on the cause, your age, and whether you want to have children in the future. Options include:
● Medications:
○ Tranexamic acid (to reduce bleeding)
○ Non-steroidal anti-inflammatory drugs (NSAIDs)
○ Hormonal birth control pills or injections
○ The hormonal IUD (Mirena) - often very effective for HMB
● Surgical options:
○ Myomectomy (removal of fibroids while keeping the uterus)
○ Uterine artery embolisation (shrinking fibroids by cutting off the blood supply)
○ Hysterectomy (removal of the uterus, typically as a last resort)
3. Lifestyle and Nutrition
● Eat iron-rich foods (spinach, beans, lentils, red meat, fortified cereals).
● Take vitamin D supplements if needed.
● Manage stress and get regular exercise.
● Track your cycle to notice changes early.
4. Find Support
You’re not alone. Many UK groups offer help and community:
● Wellbeing of Women – “Just a Period” campaign
● The Fibroid Foundation UK
● Black Women’s Health UK (BWHUK)
● Endometriosis UK – support for those with painful, heavy periods
These organisations raise awareness, offer support networks, and campaign for better menstrual healthcare for all women.
Towards Fairer Menstrual Health
For too long, women’s pain, especially Black women’s pain, has been dismissed or normalised. The good news is that things are changing. UK research and NHS guidelines now acknowledge racial disparities in menstrual and reproductive health. More clinics are adopting “one-stop” assessment models, reducing delays and improving care.
But progress also starts with awareness — knowing what’s normal, speaking openly about symptoms, and demanding care that listens and respects.
Women of African origin are statistically more likely to experience heavy menstrual bleeding, largely due to fibroids, hormonal and genetic factors, and systemic barriers to
timely care. Yet with the proper awareness, diagnosis, and treatment, you can live without constant exhaustion, pain, or embarrassment.
If your period feels too heavy, too long, or too draining, it probably is. Don’t ignore it or suffer in silence.
You deserve answers, treatment, and support.
Main Sources:
Academic & Peer-Reviewed Sources
BMJ Open (2024) Uterine fibroids and Black people of African descent globally: a narrative review. BMJ Open, 14(8): e085622. Available at: https://bmjopen.bmj.com/content/14/8/e085622 (Accessed: [2025]).
BMC Women’s Health (2024) ‘It’s just period pain’: A qualitative study exploring normalisation of menstrual symptoms and delays in help-seeking. BMC Women’s Health, 24. Available at: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-024-03008-z (Accessed: [2025]).
Laughlin-Tommaso, S.K., Jacoby, V.L. and Myers, E.R. (2017) Uterine fibroids: a review of prevalence, risk factors, and impact on quality of life. Obstetrics & Gynecology, 130(3), pp. 635–646.
Okolo, S. (2008) Incidence, prevalence and epidemiology of uterine fibroids. Best Practice & Research Clinical Obstetrics & Gynaecology, 22(4), pp. 571–588.
Stewart, E.A., Cookson, C.L., Gandolfo, R.A. and Schulze-Rath, R. (2017) Epidemiology of uterine fibroids: a systematic review. BJOG, 124(10), pp. 1501–1512.
Wellbeing of Women (2025) “Just a Period” Survey Results. Available at: https://www.wellbeingofwomen.org.uk/what-we-do/campaigns/just-a-period/just-a-period-survey-results/ (Accessed: [2025]).
Royal College of Nursing (2023) Uterine Fibroids: Clinical Guidance. Available at: https://www.rcn.org.uk/clinical-topics/Womens-health/Promoting-menstrual-wellbeing/Uterine-fibroids (Accessed: [2025]).
Wellbeing of Women / UK Parliament Health Committee (2023) Written Evidence Submission. Available at: https://committees.parliament.uk/writtenevidence/149259/pdf/ (Accessed: [2025]).
Guidelines & Policy
NICE (2018) Heavy Menstrual Bleeding: Assessment and Management (NG88). Available at: https://www.nice.org.uk/guidance/ng88 (Accessed: [2025]).
NICE (2024) Quality standard QS47: Heavy menstrual bleeding – Outpatient Hysteroscopy. Available at: https://www.nice.org.uk/guidance/qs47/chapter/Quality-statement-2-Outpatient-hysteroscopy (Accessed: [2025]).
CAHN (2025) Uterine Fibroids in Black Caribbean and African Women – Report. Caribbean and African Health Network UK. Available at: https://www.cahn.org.uk/wp-content/uploads/2025/06/Fibroids-BookletFR-1.pdf (Accessed: [2025]).
Clinical & Public Health Sources
Mayo Clinic (2023) Uterine Fibroids – Symptoms and Causes. Available at: https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288 (Accessed: [2025]).
NHS (2023) Heavy Periods – Overview. Available at: https://www.nhs.uk/conditions/heavy-periods/ (Accessed: [2025]).
Oxford University Hospitals NHS Trust (2024) Menstrual Disorder Clinic – One Stop Service. Available at: https://www.ouh.nhs.uk/services/referrals/womens/gynaecology/menstrual-clinic/ (Accessed: [2025]).
