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Thyroid Heavy Period Visit Summary

A one-page visit summary for heavy periods when thyroid questions may fit, with flow notes, symptom prompts, test-name questions, and a visit script.

Heavy bleeding can make a visit feel rushed.

This sheet helps you bring the facts first. It is for visit prep only. It does not tell you the cause.

If bleeding feels severe, sudden, unsafe, or very different for you, ask for care now.

One page heavy period summary

Fill this out before the visit.

Prompt Your note When heavy bleeding started Last period start date How many days bleeding lasted Heaviest day Products used on heaviest day Leaks through clothes or bedding Clot size Worst pain score, 0 to 10 Dizziness, weakness, fatigue, or short breath What changed from normal Thyroid question

ACOG lists patterns that can matter in heavy menstrual bleeding. These include bleeding longer than 7 days, soaking products often, needing double protection, or passing large clots.

Flow detail table

Use one row per day.

Date Period day Flow Products used Leaks Clots Symptoms Notes : 1 2 3 4 5 6 7+

Use real words.

"Changed pad every hour in the morning." "Leaked through sheets." "Clots about quarter size." "Too tired to stand long."

Thyroid context notes

Office on Women's Health says thyroid hormone changes can affect period flow.

Bring body changes that started near the same time.

Note Your answer Tiredness or low energy Feeling cold or hot Weight change Skin or hair change Neck swelling or pressure Heart racing or slow feeling Bowel change Mood, sleep, or focus change

These notes do not prove a cause. They help your clinician decide what to check.

Lab questions

MedlinePlus says thyroid tests can include TSH and T4.

Ask:

Which thyroid tests fit my symptoms? What does TSH check? What does T4 check? Do I need any other labs for heavy bleeding? Who will explain the results? How should I save the result names? What should I track while I wait? What symptoms mean I should call sooner?

Do not use a worksheet to explain a lab value. Ask for plain words.

Short visit script

If the visit is short, hand over the one page summary.

What to share

Heavy period notes can include private facts.

Share the smallest note that answers the care question.

Instead of Try first Full app export One page heavy period summary Full portal screenshot Test names and dates Every daily note Heaviest day plus symptoms Private context notes "Ask me if more context is needed." All app data Last three period dates

For a broader visit checklist, use the heavy period visit prep checklist. If bleeding will not stop, use period won't stop visit prep.

For lab privacy, read the lab results period data privacy checklist.