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Here are signs that warrant a healthcare consultation: Heavy bleeding that soaks through one pad or tampon per hour for several hours Bleeding that lasts more than 14 days in a row Bleeding after sexual intercourse , especially if its persistent Severe cramping is not typical of your usual cycle Bleeding that starts suddenly after months of no periods Signs of anemia , such as fatigue, dizziness, or shortness of breath In these cases, your provider may order blood tests , perform a pelvic exam , or recommend imaging studies to rule out other causes such as fibroids , polyps , or infections