
Heavy, painful periods with lots of clots is not normal—you don’t have to struggle! Ask for these 4 tests to figure out the cause.
Transvaginal Ultrasound for Heavy Periods
Transvaginal ultrasound is a valuable imaging technique used to investigate potentially structural changes. The radiologist (the one performing the image) will be able to detect polyps or fibroids, which are common causes of heavy periods. In addition, they will measure the endometrium lining to ensure it is the appropriate thickness for the particular time of your cycle.
Labwork: Complete Blood Count + Iron Levels
These are simple labs to check for anemia and iron deficiency. Although it is pretty common that a heavy period can cause low iron and anemia, having low iron status and anemia can actually exacerbate the amount of bleeding—and can lead to larger blood clots.
There are many reasons for being anemic or low iron status, which can include eating a vegan or vegetarian diet, gastric bypass surgery, celiac disease, increased gut permeability, blood loss in stool, post-pregnancy, and more.
Full Thyroid Panel
Our third path to investigate is your thyroid to see if there are any contributing factors related to this organ. Thyroid hormone plays multiple roles in our bodies, including playing a role in our reproductive health. In patients with low functioning thyroid, or hypothyroidism, heavy periods or more frequent periods can ensue. It is good to check thyroid labs, especially if other persisting thyroid symptoms exist such as low energy, cold intolerance, hoarse voice, constipation, hair loss, weight gain, and brittle nails.
Sex Hormones
Fourth, I like to check your sex hormones to see if an imbalance here could be contributing to heavy periods and clotting. We’re looking for estrogen dominance or progesterone deficiency.
An imbalance in estrogen, whether that is normal estrogen with progesterone deficiency, normal progesterone and estrogen excess, or the two extremes (progesterone deficiency combined with estrogen excess) can contribute to overstimulation of endometrial growth, and can result in heavy periods. Investigating the comprehensive sex hormone panel can help to identify hormonal imbalances so that modifications can take place to correct hormonal imbalances.
These hormones need to be checked at specific times of your cycle to ensure accurate readings, so make sure to consult with your provider when you make your lab appointments.
Want help figuring out your cycle? We can support you through your health journey!

Dr. Danielle Vogler-Bos is a Naturopathic Doctor, registered and licensed in both Minnesota and Arizona. Her passion is educating and empowering her patients to take back their health, partnering with them to find the root cause of their struggles, and helping them feel better, faster. After graduating from Gustavus Adolphus College with a Bachelors of Arts in Biology, Dr. Vogler-Bos earned her Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine, a fully accredited and nationally recognized institution in Phoenix, AZ.
During her clinical training, Dr. Vogler-Bos completed a rigorous internship gaining experience in the diagnosis and treatment of hormonal imbalances, thyroid disorders, and adrenal fatigue using both traditional naturopathic medicine and bio-identical hormone therapies.
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