Heavy periods when you're on heart medication

Some heart medications can cause heavy menstrual bleeding. But these medications reduce the risk of having another heart attack, so it’s important to continue taking them if you can.

If you’ve had a heart attack, or a stent put in, you will be prescribed antiplatelet medication, such as ticagrelor, prasugrel or clopidogrel (usually for a year after the heart attack) as well as aspirin, another type of antiplatelet drug (usually for life). These are to reduce the risk of blood clots forming inside the artery or the stent and causing another heart attack. Because these drugs change the way your blood clots, they can make your periods heavier.

Warfarin or other anticoagulants may cause similar issues – you may be prescribed these if you have heart valve disease, have had a valve replacement or have atrial fibrillation (AF). If you are worried about losing too much blood or it is having an impact on your daily life, make an appointment to see your GP or heart specialist. If your heart attack was more recent, you can raise it at a follow-up hospital appointment or with a nurse at cardiac rehabilitation.

You may feel embarrassed about mentioning it, but please don’t be. They may be able to change your medication or reduce your dose.  If your bleeding is very severe, your GP will be able to refer you to a specialist, as there may be some treatments to help. Hormonal methods of contraception, such as the contraceptive pill or hormonal intrauterine system (also called intrauterine device or hormonal coil) can reduce bleeding, or they may even stop your periods altogether.

A permanent option is endometrial ablation. This is a procedure which destroys your womb lining in order to reduce heavy menstrual bleeding, but this isn’t suitable for people who may want to have children. Or you can be prescribed a medicine called tranexamic acid to take during your period, which helps to reduce bleeding.

The important thing to remember is that there are options that can help you – so please don’t suffer in silence or stop taking your medication.

• Read about medicines for heart conditions