It is hard to define what heavy periods are, and also if a woman needs to be investigated to find a reason or treat a problem.
Medical assistance should be requested if:

• You become anaemic or Iron deficient as this may impair your performance or daily activities.
• You have an episode of vaginal bleeding (any amount counts) after your menopause.
• You notice a difference in the pattern of your periods.
• You notice vaginal bleeding out of your normal periods time.
• You develop pain with your periods (It should not be assume than age is related to periods problems).

There are quite a number of conditions that cause heavy or abnormal periods or abnormal vaginal bleeding.
The following are only an example:

• Hormonal causes.
• Adenomyosis:The lining of the uterus grows into the muscle or wall of the uterus.
• Fibroids: Lumps arising from the muscle of the uterus.
• Polyps: Small lumps arising from the lining of the uterus.
• Ovarian cysts
• Precancer or hyperplasia of the lining of the uterus.
• Cancer of the uterus.
• Medical conditions like thyroid disease, pelvic inflammatory disease and endometriosis.

Investigations to determine the reason for abnormal vaginal bleeding may include a pelvic scan and a hysteroscopy (where a thin telescope or hysteroscope is used vaginally and passed through the neck of the womb (cervix) into the uterus to assess the uterine cavity.

A hysteroscope is mandatory to assess properly the uterine cavity

Treatment of heavy periods or menorrhagia
Medical treatment may include non-steroidal anti-inflammatory drugs, oral contraceptive pills,, progesterone and others

Surgical treatment may involve:

• Insertion of a Mirena coil: It does release a progesterone hormone that controls the bleeding.
• Operative hysteroscopy: (to remove polyps, some type of fibroids and to exclude cancer)
• Ablation: This is the burning or destruction of the lining of the uterus to prevent it from growing again.
• Hysterectomy: The removal of the uterus (normally the ovaries are not removed).