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Early in her athletic career, Australian Olympian Jana Pittman claimed a victory at the world championships in Paris.
But instead of celebrating straight away, she had to run to the bathroom to change before a heavy period stained her clothes.
"I bled right through the racing uniform I was wearing and unfortunately, it was a light bone-coloured uniform, so there was no way I was hiding it," she said.
"I won the race, but instead of just enjoying the race and sort of doing a victory lap and then celebrating with the crowd, I darted off into the stadium cause I could feel it happening as I crossed the finish line."
Like many women, Dr Pittman spent years experiencing heavy periods, and like many women, she also thought it was something she just had to deal with.
Now training to be a gynaecologist, Dr Pittman has joined a campaign of women and experts raising awareness of heavy menstrual bleeding.
It comes as a new survey shows more than half of women who deal with heavy periods have not spoken to a health professional about it.
The research, conducted by marketing research company Two Blind Mice for medical technology company Hologic, surveyed 5,000 women aged between 35 and 52 about their periods.
It found:
- Close to 70 per cent of women have experienced heavy menstrual bleeding at some point in their lives
- Almost one in four women frequently have heavy periods
- More than half — 55 per cent — have not talked to a doctor about treatment options for heavy periods
The research also found that for many women, "embarrassment and shame" could stop them talking about heavy periods and seeking help.
Women discovering their periods are 'not normal' later in life
For Dr Pittman, it was not until after she had her first child and started studying medicine that she learned what she was dealing with was "well beyond normal".
"I ran through everything," she said.
"I never, never took a day off training or didn't race internationally, even when I had my cycle."
About 70 per cent of women agreed with the statement, "I wish I'd known a lot earlier about treatment options".
That statement rings true to Annie Gibbins, a 55-year-old business owner with five children who lives in Sydney.
She never had issues with her periods until she turned 42, when she sometimes bled so heavily she felt like she was "haemorrhaging".
Assuming it was just part of perimenopause, she did not speak to a doctor about it until she was 52.
"I got a referral to a women's health doctor and she said, 'Oh my gosh, Annie, you could have come to me years ago. This is not normal,'" she said.
What is heavy menstrual bleeding?
What is "normal" or "heavy" can vary from woman to woman, obstetrician and gynaecologist Talat Uppal says.
Releasing more than five tablespoons of blood in a single period could be considered heavy menstrual bleeding, professional guidelines say.
Needing to change pads or tampons more than once an hour, passing blood clots larger than 50 cent pieces and bleeding through clothes could also be signs that something is not right.
However, Dr Uppal, a spokesperson in the campaign, said it was more important to look at whether a woman's periods were getting in the way of everyday activities.
"If her period is resulting in a compromised quality of life, then it's heavy menstrual bleeding," she said.
Women's Gynaecology Research Centre research fellow Michelle Peate, who was not involved with the latest survey, agreed.
"If you are finding that your symptoms are interfering with your daily living — whether that's being anxious about going out or going to school or going to work … if you are also having pain and it's really severe that's affecting the way you think — go get some help," Dr Peate said.
"Go see your GP and tell them how much it's impacting your life."
Are there treatments for heavy menstrual bleeding?
There are multiple treatment options available for women with heavy periods, Dr Uppal said.
These include different types of birth control, medications and intra-uterine devices, as well as surgical options.
"Women typically are quite resilient, so they do try to put up with things and try to make it work," she said.
"But it kind of disadvantages their care because they might have lost an opportunity for timely options."
The new survey also showed a majority of women — close to 70 per cent — believed more awareness and open conversations about heavy periods would be beneficial.
Women like Dr Pittman and Ms Gibbins hope sharing their stories helps.
"I don't think you should be living with something just because you can be stoic. I think if there's something you can do about it, we should," Dr Pittman said.