Intrauterine system (IUS)
The IUS, or levonorgestrel-releasing intrauterine system, is a small plastic device inserted into your womb by a doctor or nurse. It slowly releases a hormone called progestogen.
It prevents the lining of your womb growing quickly and is also a contraceptive. An IUS doesn't affect your chances of getting pregnant after you stop using it.
Possible side effects of using an IUS include:
- irregular bleeding that may last more than 6 months
- breast tenderness
- stopped or missed periods
An IUS is often the preferred first treatment for women with heavy menstrual bleeding, but it can take at least 6 periods for you to start seeing the benefits.
You may be prescribed tranexamic acid tablets if an IUS is unsuitable or you're waiting for further tests or another treatment.
The tablets work by helping the blood in your womb to clot.
Tranexamic acid tablets are usually taken 3 times a day for a maximum of 4 days. You start taking the tablets as soon as your period starts.
Tranexamic acid tablets are not a form of contraception and won't affect your chances of becoming pregnant. If necessary, tranexamic acid can be combined with a non-steroidal anti-inflammatory drug (NSAID).
Possible side effects of tranexamic acid include:
- feeling sick
- being sick
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs can also be used to treat heavy periods if an IUS isn't appropriate, or if you're waiting for further tests or a different treatment.
They're taken in tablet form from the start of or just before your period, until heavy bleeding has stopped.
NSAIDs used for treating heavy menstrual bleeding include:
Mefenamic acid and naproxen are only available on prescription.
NSAIDs work by reducing your body's production of a hormone-like substance called prostaglandin, which is linked to heavy periods. NSAIDs can also help relieve period pain. They're not a form of contraceptive.
You can keep taking NSAIDs for as long as you need to if they're making your bleeding less heavy and not causing significant side effects.
Make sure you do not take more than the recommended daily dose listed on the packet.
Combined oral contraceptive pill
The combined contraceptive pill can be used to treat heavy periods. It contains the hormones oestrogen and progestogen.
The benefit of using combined oral contraceptives as a treatment for heavy periods is they offer a more readily reversible form of contraception than the IUS.
They also have the benefit of regulating your menstrual cycle and reducing period pain.
The pill works by preventing your ovaries releasing an egg each month. As long as you're taking it correctly, it should prevent pregnancy.
Common side effects of the combined oral contraceptive pill include:
- mood changes
- feeling sick (nausea)
- breast tenderness
If other treatments have not helped, you may be offered a type of medicine called cyclical progestogen.
It's taken in tablet form for part of your menstrual cycle. Your doctor will advise you how to take it.
It's not an effective form of contraception and can have unpleasant side effects, including:
- breast tenderness
- bleeding between your periods
Endometrial ablation involves thinning, removing or destroying the lining of the womb (the endometrium). It may lighten your periods or stop them all together, depending on how much of your womb lining remains.
Different techniques can be used for endometrial ablation, including:
- endometrial ablation using heat – an electrical source, radio waves or lasers are used to destroy the womb lining via the vagina and cervix
- endometrial ablation using ultrasound energy – high levels of ultrasound energy from outside the body are used to destroy fibroids without harming healthy womb lining
You may experience some vaginal bleeding, like a light period, for a few days after endometrial ablation. Use sanitary towels rather than tampons. Some women can have bloody discharge for 3 or 4 weeks.
Some women have reported experiencing more severe or prolonged pain after having endometrial ablation. In this case, you should speak to your GP or a member of your hospital care team who may be able to prescribe a stronger painkiller.
It's unlikely you'll be able to get pregnant after endometrial ablation. If you do, you'll have an increased risk of miscarriage or other complications. The procedure is not recommended if you still want to have children.
Sometimes, endometrial ablation does not lighten the periods, or the heavy periods may come back. If this happens you may be offered a repeat treatment.
Uterine artery embolisation (UAE)
If your heavy periods are caused by fibroids, UAE may be an option.
This involves blocking the blood vessels that supply the fibroids, causing them to shrink. Under X-ray guidance, a small tube is inserted into the large blood vessel in your thigh.
Small particles are injected through the tube to block the arteries supplying blood to the fibroid.
Read more about UAE on our page about treatments for fibroids.
Myomectomy is another treatment option for heavy periods caused by fibroids. It involves surgery to remove fibroids from the wall of your womb.
Read more about myomectomy on our page about treating fibroids.
Removal of the womb (hysterectomy)
A hysterectomy will stop any future periods but should only be considered after other options have been tried or discussed.
The operation and recovery time are longer than for other types of surgery for treating heavy periods.
You will not be able to get pregnant after having a hysterectomy.
A hysterectomy is only used to treat heavy periods after a thorough discussion with your specialist about the benefits and disadvantages of the procedure.