Treatment options for heavy periods 

Treatment
Pros
Cons

Medication

Levonorgestrel-releasing intrauterine system (LNG-IUS)

The levonorgestrel-releasing intrauterine system (LNG-IUS) is a small plastic intrauterine device (IUD) that's inserted into your womb and slowly releases a hormone called progestogen

  • Can reduce blood loss by over 90%
  • Also acts as a contraceptive
Tranexamic acid

Tranexamic acid is taken as a tablet three times a day from the start of your period, for a maximum of three to four days. It helps the blood in your womb clot

  • Can be used if LNG-IUS isn't suitable
  • Some forms are available without prescription
  • Can reduce blood loss by 50%
  • Doesn’t act as a contraceptive
  • Possible side effects include indigestion and diarrhoea
  • Less effective than LNG-IUS
  • Doesn’t act as a contraceptive

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are common painkillers that can reduce the production of a number of chemicals linked with heavy periods. They're taken regularly from the start of your period (or just before) until heavy bleeding stops

  • Can be used if LNG-IUS isn't suitable
  • May be combined with tranexamic acid or the combined oral contraceptive pill
  • Can also reduce painful periods
  • Easily available
  • Can reduce blood loss by 20-50%
  • Doesn’t act as a contraceptive

  • Possible side effects include indigestion and diarrhoea
  • Doesn’t act as a contraceptive
  • Shouldn't be used by women with bleeding or clotting disorders, or women at a high risk of stomach ulcers

Combined oral contraceptive pill

The combined contraceptive pill ("the pill") can be used to treat heavy periods. You take one pill every day for 21 days, before stopping for seven days. You get your period during the seven-day break

  • Can reduce blood loss by about 40%
  • You have more control over starting and stopping contraception than with LNG-IUS
  • Reduces period pain 
  • Also acts as a contraceptive
  • Possible side effects include mood changes, nausea, fluid retention and breast tenderness
  • Also acts as a contraceptive

Oral norethisterone

Norethisterone is a man-made hormone that can be used to treat heavy periods. It's taken in tablet form, two to three times a day from days five to 26 of your menstrual cycle, counting the first day of your period as day one

  • Can reduce blood loss by over 80%
  • Not an effective form of contraception
  • Not suitable for women trying to conceive because it can inhibit ovulation
  • Possible side effects include weight gain, breast tenderness and short-term acne
  • Not an effective form of contraception

Injected progestogen

A type of progestogen called medroxyprogesterone acetate is an injection that's sometimes used to treat menorrhagia

  • Bleeding stops completely in up to 50% of women after a year of treatment
  • Only one injection is needed every 12 weeks
  • Also acts as a contraceptive
  • Possible side effects include weight gain, bloating and breast tenderness
  • Also acts as a contraceptive

Gonadotropin releasing hormone analogue

Gonadotropin releasing hormone analogue (GnRH-a) is a type of hormone sometimes given as an injection to treat heavy periods

  • Bleeding stops completely in 89% of women
  • Can be used while you wait for surgery
  • Can cause hormonal changes, similar to the menopause, including side effects such as hot flushes, increased sweating and vaginal dryness
  • Not a routine treatment due to side effects

Surgery

Uterine artery embolisation (UAE)

If heavy periods are caused by fibroids, UAE is an operation that can slowly shrink the growths

  • Often successful in women with heavy periods caused by fibroids
  • Serious complications are rare
  • Only requires one night in hospital and local anaesthetic
  • Can cause pain for a few hours afterwards
  • In 10-20% cases, UAE is needed again later on
  • Not effective if heavy periods aren't caused by fibroids
  • The effects of UAE on your ability to get pregnant are uncertain
Myomectomy

Myomectomy is the surgical removal of fibroids from your womb

  • Can reduce blood loss caused by fibroids
  • Not suitable for all types of fibroid
  • Fibroids sometimes grow back
  • Not effective if heavy periods aren't caused by fibroids
  • Requires general anaesthetic and a hospital stay of up to five days
Endometrial ablation

Endometrial ablation is a procedure that can be used to treat heavy periods by destroying most of your womb lining with heat, a laser or microwaves

  • Should stop heavy bleeding
  • Fairly quick to perform and you can often go home the same day
  • May experience vaginal bleeding and tummy cramps afterwards, which can last for a few days or weeks
  • Womb lining may grow back, so repeat surgery may be needed
  • Attempting to get pregnant after endometrial ablation isn't recommended because the risk of problems like miscarriage is high

Hysterectomy

hysterectomy is the surgical removal of the womb

  • You'll no longer be able to get pregnant
  • Requires general anaesthetic and a hospital stay of up to five days
  • Complications include early menopause and infection