Heavy Periods: Causes, Symptoms & Treatment Options in London
Heavy periods (medically called menorrhagia) are defined as soaking through a pad or tampon every one to two hours, passing clots larger than a 50p coin, or bleeding for more than 7 days. If heavy menstrual bleeding is disrupting your work, sleep, or daily life, there is almost always an identifiable cause and effective treatment available at a private gynaecology clinic in London.
- Heavy periods are defined by soaking through protection hourly, passing large clots, or bleeding beyond 7 days.
- Fibroids and adenomyosis are the two most common structural causes of heavy menstrual bleeding.
- Heavy periods are a leading cause of iron-deficiency anaemia in UK women.
- Multiple effective treatments exist — from the Mirena coil to Sonata fibroid ablation — without needing open surgery.
- Mr Mahantesh Karoshi specialises in diagnosing and treating heavy periods at his London clinic.
- No GP referral needed. Private appointments available.
Heavy Periods in Numbers: The Scale of the Problem
Heavy menstrual bleeding affects a significant proportion of women in the UK. These figures help illustrate why it should never be dismissed as something to simply live with.
What Are Heavy Periods?
Heavy periods, clinically known as menorrhagia, refer to menstrual bleeding that is abnormally heavy or prolonged. There is no single measurement that defines it precisely, because blood loss varies between women. Clinically, the following are used as indicators:
- Needing to change a pad or tampon every one to two hours for several consecutive hours
- Using double protection (pad and tampon) simultaneously
- Passing blood clots larger than a 50p coin
- Bleeding for more than 7 days
- Bleeding through clothing or onto bedding
- Feeling so fatigued that daily activities are affected
Heavy cycles affect far more than just physical health. Many women report that heavy periods interfere with work, social life, sleep, exercise, and emotional wellbeing. This is not something you should have to manage alone.
What Causes Heavy Periods?
Heavy menstrual bleeding is almost always caused by an identifiable underlying condition. The most common causes seen at Mr Karoshi’s London clinic are listed below.
1. Uterine Fibroids
Fibroids are non-cancerous growths of the uterine muscle wall. They are one of the most frequent causes of heavy periods. Fibroids distort the shape of the uterine cavity and increase the surface area of the endometrial lining, leading to significantly heavier and often more prolonged bleeding. Mr Karoshi is a recognised specialist in fibroid treatment in London, including the minimally invasive Sonata radiofrequency ablation procedure.
2. Adenomyosis
Adenomyosis occurs when the endometrial tissue (the lining of the womb) grows into the muscular wall of the uterus itself. This causes the uterus to become enlarged and leads to heavy, prolonged, and often very painful periods. Adenomyosis is frequently underdiagnosed. Mr Karoshi has extensive experience in its identification and management.
3. Endometriosis
Endometriosis, where tissue similar to the uterine lining grows outside the womb, commonly causes heavy and painful menstrual cycles. It also frequently causes pelvic pain and pain during sex. Around 1 in 10 UK women are affected. See Mr Karoshi’s endometriosis service page for more information.
4. Endometrial Polyps
Endometrial polyps are small, non-cancerous outgrowths from the lining of the womb. They frequently cause heavy periods, irregular bleeding, and spotting between cycles. They are identified via ultrasound or hysteroscopy and are straightforward to treat.
5. Hormonal Imbalance
When oestrogen and progesterone are out of balance, the endometrium (womb lining) can become thicker than normal. When this thickened lining is shed during menstruation, it results in heavier and longer bleeding. Hormonal imbalance is particularly common in the years approaching the menopause (perimenopause) and in the early teenage years.
6. Polycystic Ovary Syndrome (PCOS)
PCOS can cause irregular and infrequent periods, but when a period does occur after a long gap, the endometrium has had more time to thicken and the resulting bleed can be very heavy. Some women with PCOS experience unpredictably heavy menstrual cycles for this reason.
7. Thyroid Disorders
An underactive thyroid (hypothyroidism) directly affects the hormones that regulate the menstrual cycle. Women with undiagnosed or undertreated hypothyroidism often experience heavier, more frequent periods. A simple blood test as part of a menstrual assessment will identify this.
8. Blood Clotting Disorders
Conditions affecting the blood’s ability to clot, such as von Willebrand disease, can cause abnormally heavy menstrual bleeding. These are often overlooked in the initial assessment of heavy periods but are important to identify because they change the treatment approach significantly.
9. Intrauterine Device (Copper Coil)
The non-hormonal copper IUD (coil) is well-known to cause heavier periods as a side effect. If heavy cycles began shortly after a copper coil was fitted, this is likely the cause. Switching to the hormonal Mirena coil often resolves the problem entirely.
10. No Structural Cause Found
In a proportion of women, no structural or hormonal cause is identified after full investigation. This is called heavy menstrual bleeding of unknown cause, or previously referred to as dysfunctional uterine bleeding. Effective treatment options are still available even without a specific underlying diagnosis.
Causes of Heavy Periods: Quick Reference Table
| Cause | Key Features | Who It Affects Most | Treatable? |
|---|---|---|---|
| Uterine fibroids | Very heavy, prolonged bleeding, clots | Women aged 30–50 | Yes |
| Adenomyosis | Heavy, painful, prolonged periods | Women aged 35–50 | Yes |
| Endometriosis | Heavy, painful, pelvic symptoms | Women aged 20–45 | Yes |
| Endometrial polyps | Heavy periods, irregular spotting | Women aged 40–50 | Yes |
| Hormonal imbalance | Heavier than normal, cycle changes | Perimenopause, teenagers | Yes |
| PCOS | Infrequent but very heavy bleeds | Women aged 15–44 | Yes |
| Thyroid disorder | Heavy and frequent periods | Any age | Yes |
| Clotting disorder | Heavy from first period, easy bruising | Any age, often lifelong | Managed, not cured |
| Copper coil | Heavy periods after fitting | Any age | Yes – remove or switch |
| Unknown cause | No structural finding | Any age | Treatment still effective |
Concerned about heavy periods?
Mr Mahantesh Karoshi offers expert assessment and treatment at his London clinic. Find the cause. Get the right treatment. No GP referral needed.
Book a Consultation ↗ Heavy Periods ServiceSymptoms of Heavy Periods: What to Watch For
Heavy menstrual bleeding rarely presents in isolation. The symptoms below, particularly when they occur together, indicate that a specialist assessment is warranted.
- Soaking through a pad or tampon every one to two hours for several hours in a row
- Needing to use both a tampon and pad simultaneously for adequate protection
- Passing blood clots larger than a 50p coin
- Periods lasting longer than 7 days
- Bleeding through clothing or bedding at night
- Needing to restrict activities, work, or social plans due to bleeding
- Fatigue, breathlessness, or dizziness (signs of anaemia from blood loss)
- Pale skin, difficulty concentrating, or feeling cold — further anaemia indicators
- Pelvic pressure, bloating, or pain during or between periods
- Significant worsening of bleeding over recent months
Important: Heavy periods that are getting progressively worse, or that are accompanied by bleeding between periods or after sex, always require prompt specialist assessment. These symptoms should not be waited on. Book a consultation with Mr Karoshi today.
Can Heavy Periods Cause Anaemia?
Yes. Heavy menstrual bleeding is one of the leading causes of iron-deficiency anaemia in women of reproductive age in the UK. Each menstrual cycle depletes iron from the body. When blood loss is consistently heavy, the body cannot replenish iron stores fast enough.
Symptoms of anaemia caused by heavy periods include:
- Persistent fatigue and low energy
- Breathlessness on mild exertion
- Pale skin, pale inner eyelids, pale nail beds
- Dizziness or light-headedness, particularly when standing
- Difficulty concentrating or brain fog
- Frequent headaches
- Heart palpitations
Many women live with these symptoms for years without connecting them to their period. If you recognise these signs, a blood test as part of Mr Karoshi’s assessment will confirm whether anaemia is present and how severe it is.
How Are Heavy Periods Diagnosed in London?
At Mr Karoshi’s London gynaecology clinic, the diagnostic process is thorough and efficient.
Detailed Medical History
Mr Karoshi begins with a structured consultation covering your full menstrual history, when heavy bleeding started or worsened, associated symptoms, current contraception, previous pregnancies, and any relevant family history. This shapes the entire investigation.
Blood Tests
A full blood count checks for anaemia and assesses its severity. Thyroid function, clotting factors, hormone levels (FSH, LH, oestrogen, progesterone), and iron stores are also assessed where clinically indicated.
Pelvic Ultrasound Scan
Ultrasound is the primary imaging tool for identifying fibroids, adenomyosis, ovarian cysts, and endometrial polyps. A transvaginal ultrasound provides the clearest view of the uterine structure and lining thickness. This is performed comfortably at the clinic.
Hysteroscopy
Where polyps, fibroids inside the uterine cavity (submucosal fibroids), or abnormalities of the womb lining are suspected, a hysteroscopy may be recommended. This involves a slim telescope passed through the cervix to directly visualise the inside of the womb. It can be both diagnostic and therapeutic in the same procedure.
Endometrial Biopsy
A small sample of the womb lining may be taken to assess for cellular changes, particularly in women over 40 with unexplained heavy bleeding, to rule out endometrial hyperplasia or, in rare cases, endometrial cancer.
How Are Heavy Periods Treated in London?
Treatment is carefully matched to the underlying cause, your age, symptom severity, and whether you wish to preserve fertility. Mr Karoshi always recommends the least invasive effective treatment first.
The Mirena Hormonal Coil (LNG-IUS)
The Mirena coil releases a small amount of levonorgestrel (a progestogen) locally within the uterus. It thins the endometrial lining significantly, reducing bleeding by up to 90% in most women. It is highly effective, long-lasting (up to 5 years), reversible, and is the first-line recommended treatment in NICE guidelines for heavy menstrual bleeding with no underlying structural cause.
Tranexamic Acid
Tranexamic acid is a non-hormonal tablet taken during the period. It works by reducing the breakdown of blood clots within the uterus, reducing blood flow. It does not affect hormone levels and is suitable for women who prefer non-hormonal options or who are trying to conceive.
Hormonal Treatments
The combined oral contraceptive pill, progesterone-only pill, or injectable progesterone can reduce the thickness of the endometrial lining and therefore the volume of bleeding. These are particularly useful where contraception is also needed and no structural cause has been identified.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Medications such as mefenamic acid reduce both blood loss and period pain. They are taken during the period and work by reducing prostaglandin levels. They are most effective where heavy periods are associated with significant cramping.
Sonata Radiofrequency Ablation (For Fibroids)
Mr Karoshi is experienced in the Sonata procedure, a minimally invasive treatment for uterine fibroids that uses radiofrequency energy to destroy fibroid tissue from inside the uterus. There is no incision, no overnight stay, and recovery is rapid. It is an excellent option for women with fibroid-related heavy bleeding who wish to avoid hysterectomy. Read more about fibroid treatments at Mr Karoshi’s London clinic.
Endometrial Ablation
Endometrial ablation destroys the lining of the womb, significantly reducing or stopping periods altogether. It is a minimally invasive procedure performed under general or local anaesthetic, with a short recovery time. It is suitable for women who have completed their family and have no structural fibroid causing the bleeding.
Hysterectomy
Removal of the uterus (hysterectomy) is the only permanent cure for heavy periods. Mr Karoshi recommends it only when all other appropriate options have been tried or considered, or when there is an additional indication such as severe fibroids or adenomyosis. Where hysterectomy is the right choice, minimally invasive approaches are used wherever possible.
Treatment Options for Heavy Periods: At a Glance
| Treatment | Best For | Fertility Preserved? | How Effective? |
|---|---|---|---|
| Mirena coil (LNG-IUS) | Most women, first-line option | Yes | Up to 90% reduction |
| Tranexamic acid | Non-hormonal preference, trying to conceive | Yes | 25–50% reduction |
| Combined pill | Contraception needed, no structural cause | Not while taking | Good cycle control |
| Mefenamic acid (NSAID) | Heavy periods with pain | Yes | 25–35% reduction |
| Sonata fibroid ablation | Fibroid-related heavy bleeding | Often yes | Significant reduction |
| Endometrial ablation | Family complete, no large fibroids | No | 80–90% reduction |
| Hysterectomy | Severe cases, family complete | No | 100% – permanent |
Speak With a Specialist About Heavy Periods
There is a treatment that is right for you. Mr Karoshi will take the time to explain every option clearly, without pressure. Private appointments in London, no GP referral needed.
Speak With a Specialist ↗ About This ServiceWhen Should You See a Gynaecologist About Heavy Periods?
Heavy periods should always be assessed by a specialist if they meet any of the following criteria.
- You are soaking through protection every one to two hours
- You are passing clots larger than a 50p coin
- Your periods last longer than 7 days
- You have experienced symptoms of anaemia such as fatigue, breathlessness, or dizziness
- Your bleeding is getting progressively heavier over time
- Heavy bleeding is accompanied by significant pelvic pain
- You experience bleeding between periods, after sex, or after the menopause
- Heavy periods are affecting your work, sleep, exercise, or social life
- You have a suspected fibroid, adenomyosis, or endometriosis
In Mr Karoshi’s own words: “Heavy periods are one of the most common reasons women come to see me, and also one of the most undertreated. Many women assume they simply have to manage it. In almost every case I see, there is an explanation and there is something we can do. No woman should be restricting her life around her period.”
Why Choose Mr Mahantesh Karoshi for Heavy Period Treatment in London?
When choosing a private gynaecologist in London for heavy periods, the right specialist combines diagnostic accuracy with a treatment approach that is tailored to your circumstances. Here is what distinguishes Mr Karoshi’s practice.
Mr Mahantesh Karoshi
Consultant Gynaecologist, London — MBBS, MD, FRCOG- 33+ years of clinical experience in obstetrics and gynaecology
- Fellow of the Royal College of Obstetricians and Gynaecologists (FRCOG)
- Specialist in fibroids, adenomyosis, heavy periods, and menstrual disorders
- Advanced training in Sonata radiofrequency fibroid ablation
- Outstanding Patient Experience Award – 2025 and 2026
- Published researcher and international educator in women’s health
Mr Karoshi believes that no woman should have to manage heavy periods alone. His London clinic offers specialist assessment with a focus on finding the real cause, explaining all options clearly, and providing treatment that works for your life.
Frequently Asked Questions About Heavy Periods
What counts as a heavy period?
A period is considered heavy when you need to change protection every one to two hours for several consecutive hours, when you pass clots larger than a 50p coin, when bleeding lasts more than 7 days, or when it significantly interferes with your daily life.
What causes heavy periods?
The most common causes include uterine fibroids, adenomyosis, endometriosis, endometrial polyps, hormonal imbalance, PCOS, thyroid disorders, and blood clotting conditions. A thorough assessment at Mr Karoshi’s London clinic identifies the cause quickly.
When should I see a doctor about heavy periods?
You should see a gynaecologist if heavy periods are affecting your daily life, if you are passing large clots, bleeding for more than 7 days, experiencing fatigue or breathlessness, or if your bleeding has worsened significantly over recent months.
Can heavy periods cause anaemia?
Yes. Heavy menstrual bleeding is one of the leading causes of iron-deficiency anaemia in UK women. Losing too much blood each month depletes iron stores faster than the body can replenish them, causing fatigue, breathlessness, dizziness, and pale skin.
How are heavy periods treated in London?
Treatment depends on the cause and your fertility plans. Options include the Mirena hormonal coil, tranexamic acid, hormonal therapies, endometrial ablation, Sonata fibroid ablation, and in some cases hysterectomy. Mr Karoshi will always recommend the least invasive effective option first.
Are heavy periods a sign of cancer?
Heavy periods are rarely a sign of cancer. The vast majority of cases are caused by benign conditions such as fibroids or hormonal imbalance. However, bleeding between periods, after sex, or after the menopause should always be assessed promptly by a specialist.
Do I need a GP referral to see Mr Karoshi about heavy periods?
No. You can book a private consultation directly at Mr Karoshi’s London clinic without a GP referral. Appointments are available for all menstrual health concerns including heavy periods, fibroids, and adenomyosis.
Conclusion
Heavy periods are not something you have to endure. Whether your bleeding is caused by fibroids, adenomyosis, a hormonal imbalance, or another condition, there are real, evidence-based solutions that can significantly improve your quality of life.
The key is an accurate diagnosis followed by a treatment plan that is matched to your specific situation, your stage of life, and your personal preferences. Mr Karoshi takes the time to understand your full picture before recommending anything.
With over 33 years of experience treating menstrual disorders in London, access to advanced procedures including Sonata fibroid ablation, and a consistent record of outstanding patient experience, Mr Mahantesh Karoshi offers the specialist care that heavy periods deserve.
Contact Mr Mahantesh Karoshi Today
If heavy periods are affecting your life, do not wait. Book a private consultation in London and get a clear diagnosis and a treatment plan that works for you. No GP referral needed.
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