There are many options available to treat heavy periods.
Your treatment options depend on:
- your symptoms
- your general health
- what is causing your heavy periods
- if you're trying to get pregnant or want to in the future
- your personal preferences
Discuss the benefits and risks of the different options with your doctor. Some treatments may have an impact on your future fertility.
Medicines without hormones
There are medicines that do not contain hormones that can help you manage heavy periods.
Tranexamic acid
Your GP may prescribe tranexamic acid if:
- an IUS is unsuitable
- you're waiting for more tests or another treatment
You take tranexamic acid as tablets. It works by helping the blood in your womb to clot.
Tranexamic acid tablets are usually taken 3 times a day for 4 days. You start taking the tablets as soon as your period starts.
Tranexamic acid tablets are not a form of contraception. They do not affect your chances of becoming pregnant.
Your GP may prescribe tranexamic acid with a non-steroidal anti-inflammatory drug (NSAID).
Possible side effects of tranexamic acid include:
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs for treating heavy periods include:
- ibuprofen
- mefenamic acid
- naproxen
You need a prescription for mefenamic acid and naproxen.
NSAIDs can treat heavy periods if:
- an IUS is not an option
- you're waiting for more tests or another treatment
You can take them in tablet form.
You can take NSAIDs from just before or the start of your period until the heavy bleeding stops.
NSAIDs work by reducing your body's production of a hormone-like substance called prostaglandin. This is linked to heavy periods. NSAIDs can also help relieve period pain.
You can keep taking NSAIDs for as long as you need to if they reduce the bleeding and do not cause serious side effects.
Do not take more than the recommended daily dose listed on the packet.
Learn more about NSAIDs.
Medicines with hormones
There are medicines that contain hormones that can help you manage heavy periods.
Combined oral contraception (the pill)
The pill can treat heavy periods. It contains the hormones oestrogen and progestogen.
The pill:
- is a more reversible form of contraception than the IUS
- can regulate your menstrual cycle
- can reduce period pain
The pill works by preventing your ovaries from releasing an egg each month. As long as you take it correctly, it should prevent pregnancy.
Common side effects of the combined oral contraceptive pill include:
- mood changes
- feeling sick (nausea)
- headaches
- breast tenderness
Combined oral contraception (the pill) - sexualwellbeing.ie
Cyclical progestogens
If other treatments have not helped, your GP may prescribe cyclical progestogens.
It's taken in tablet form for part of your menstrual cycle. Your GP will tell you how to take it.
Cyclical progestogens is not contraception.
It can have unpleasant side effects, including:
- breast tenderness
- bleeding between your periods
Intrauterine system (IUS)
The IUS is a small plastic device that's put in your womb by your doctor or nurse. It slowly releases a hormone called progesterone. This treatment prevents the lining of your womb from growing quickly.
An IUS is usually the preferred first treatment for heavy periods. But it can take at least 6 periods for you to start seeing the benefits.
The IUS is a contraceptive. But it does not 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
- acne
- stopped or missed periods
Endometrial ablation
Endometrial ablation involves thinning, removing or destroying the lining of the womb (the endometrium).
It may lighten your periods or stop them completely. This depends on how much of your womb lining remains.
Endometrial ablation can be done using:
- heat - your doctor uses an electrical source, radio waves or lasers to destroy the womb lining (this is done through the vagina and cervix)
- ultrasound energy - your doctor uses high levels of ultrasound energy from outside the body to destroy fibroids (this does not harm healthy womb lining)
You can have these procedures in a hospital under local anaesthetic or general anaesthetic. You can usually go home on the same day.
After the procedure, you may have:
- some vaginal bleeding, like a light period, for a few days - use pads rather than tampons
- bloody discharge for 3 or 4 weeks
- tummy cramps, like period pains, for a day or 2 - your doctor may recommend painkillers, such as paracetamol or ibuprofen
- more severe or continued pain - this is rare but if this happens, speak to your GP or hospital care team, they may 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 and heavy periods may come back. If this happens you may have the treatment again.
Uterine artery embolisation (UAE)
If large fibroids cause your heavy periods, you may be offered UAE. You will need to have an MRI first.
Your doctor puts a small tube into the large blood vessel in your thigh. They inject small particles through the tube to block the arteries supplying blood to the fibroid. This causes them to shrink.
Myomectomy
If your heavy periods are caused by fibroids, myomectomy is another treatment option.
It involves surgery to remove fibroids from the wall of your womb. You may need to stay in hospital if you have surgery to remove large fibroids.
Removal of the womb (hysterectomy)
A hysterectomy is a major surgical procedure to remove the uterus (womb). This will stop any future periods.
It is only considered after:
- other options have been tried or discussed
- you discuss the benefits and risks of the procedure with your specialist
The operation and recovery time are longer than other types of surgery for heavy periods.
You will not be able to get pregnant after having a hysterectomy.
Content supplied by the NHS and adapted for Ireland by the HSE
