Heavy periods, also known as menorrhagia, can be painful, make you feel miserable and interfere with your day-to-day life.
Some women may find relief from heavy period pains by taking paracetamol or other pain relief treatments such as Ibuprofen or Naproxen. However, if your periods are stopping you from your normal daily routine, you should speak to your doctor about other possible treatments you can have.
Sometimes, there is no obvious underlying reason for heavy periods. However, in some cases, there are several health conditions that can cause heavy menstrual bleeding, including:
Fibroids
These are non-cancerous growths that develop in or around the womb.
Endometriosis
This is where the tissue that lines the womb (endometrium) is found outside the womb, such as in the ovaries and fallopian tubes.
Underactive thyroid (hypothyroidism)
This can make your womb lining thicker than usual, causing heavy bleeding when it sheds during your period.
Adenomyosis
This is when tissue from the womb lining becomes embedded in the wall of the womb.
Pelvic inflammatory disease (PID)
This is an infection in the upper genital tract (the womb, fallopian tubes or ovaries) that can cause symptoms like pelvic or abdominal pain, bleeding after sex or between periods, vaginal discharge and a high temperature.
Endometrial polyps
These are non-cancerous growths in the lining of the womb or cervix.
Endometrial cancer
The most common symptom is abnormal bleeding, especially after the menopause.
Polycystic ovary syndrome (POS)
This condition affects how the ovaries work and causes irregular periods. When periods do start again, they can be heavier than usual.
It is recommended to speak to your doctor if you have noticed a change in your periods, such as bleeding more than usual, experiencing more pain than usual or noticing blood clots in your period.
The type of treatment depends on what is causing you to have heavy periods and your overall general health.
The treatment options include medicines and medical devices, as well as non-surgical and surgical treatments. Here, we will break down these options, explaining what they are and how they work to relieve your heavy and painful periods.
Your doctor may recommend or prescribe a medicine to treat your heavy periods. They may suggest or prescribe a treatment like Tranexamic Acid 500mg or Norethisterone. Speak to your doctor before buying any medicine or consult our online clinicians for further advice.
Medicines without hormones
e.g. tranexamic acid or non-steroidal anti-inflammatory drugs (NSAIDs).
Tranexamic acid is used to prevent major blood loss. It works by thickening (clotting) the blood to prevent it from flowing as freely. As a result, menstrual bleeding is slowed down. This treatment is only available on prescription and should be discussed with your doctor.
NSAIDs are often used to treat pain. They block a hormone in your body called prostaglandin, which is created in the lining of your uterus at the start of your menstrual cycle. During menstruation, prostaglandins are released from cells in the uterine lining and get to work, constricting the blood vessels and contracting muscles around the uterus to aid the shedding of the endometrium. It is this contraction which causes the pain.
e.g. the combined oral contraceptive pill or progestogen tablets, such as the mini pill.
Contraceptive pills are typically used to prevent unwanted pregnancy, but they can also help to regulate the menstrual cycle. While taking the contraceptive pill, periods may become more regular, lighter and less painful. There are a range of different contraceptive pills available, so it's best to discuss your options with your doctor.
An intrauterine system (IUS)
This is a small device inserted into your womb which releases the hormone progestogen. While it is primarily used as a contraceptive, it can also help to regulate periods, making them lighter and less painful, much like a contraceptive pill.
It's important to note that an intrauterine system (IUS) is different from an intrauterine device (IUD). An IUD is a copper device which does not secrete hormones, while an IUS releases a progestogen hormone. For more information about IUDs and IUSs', it is best to speak to your doctor or a sexual health nurse.
If your heavy periods are caused by fibroids, there is a non-surgical procedure which is used to shrink the size of the growths called a uterine artery embolisation.
As the name suggests, it involves purposely obstructing a blood vessel around the uterus to cut the supply of blood to the fibroids. The procedure involves inserting a catheter, usually under local anaesthetic, into the uterine artery and injecting small particles to block the blood supply.
By starving the fibroids' blood supply, the growth shrinks, and the symptoms subside.
Endometrial ablation
This is a procedure to remove the lining of the womb.
Myomectomy
The surgical removal of fibroids.
Hysterectomy
This is a surgery to remove the womb completely. You'll no longer be able to become pregnant after you have this procedure.
Remember, the treatment options depend on any existing health conditions, your age, the type of abnormal bleeding you are experiencing and how long you are bleeding. You should discuss the available treatments openly with your doctor to determine the best course of action for you.
It can be difficult to establish if your periods are normal or heavy. Every woman is different, so how would you know your menstrual bleeding is heavy? Well, over time, you would recognise how much blood you lose during your periods by how many tampons/sanitary pads you go through. If you notice any of the following changes, it would be an indication that your period is heavy:
The first thing to do when you notice you are experiencing heavy periods is to speak to your doctor. Your period is unique to you, so the type of treatment you are advised will be linked to your medical history.
Remember, heavy bleeding during your period is nothing to be ashamed of. Around a third of women in the UK aged 30-49 get heavy periods. If you think your periods are heavy, speak to your doctor before you start any type of treatment. They can discuss your individual options and advise on which route is best for your body.
NHS, 2018. Heavy periods.
NICE, 2010. Uterine artery embolisation for fibroids, Chapter 2, The Procedure.
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