What is heavy periods (menorrhagia)?
Heavy menstrual bleeding, or menorrhagia, means periods that are heavy or prolonged enough to affect your quality of life — needing to change protection every hour or two, passing large clots, bleeding through clothes or bedding, or bleeding for more than seven days. Around a quarter of women experience heavy periods at some point. Causes include fibroids, polyps, endometriosis, adenomyosis, hormonal imbalance and clotting disorders, although often no underlying cause is found.
Assessment starts with a history and blood tests to check for anaemia, followed where needed by a pelvic ultrasound and sometimes hysteroscopy — a thin camera passed into the womb — to examine the lining directly. Treatment then depends on the cause, your age and whether you plan to have children.
Common symptoms
- Soaking through pads or tampons every one to two hours
- Passing large blood clots
- Bleeding lasting more than seven days
- Flooding through to clothes or bedding
- Needing double protection or overnight changes
- Tiredness or breathlessness from anaemia
- Period pain alongside heavy flow
How long will you wait?
Heavy bleeding referrals join some of the longest queues in the NHS because gynaecology is among the most pressured specialties; many women wait well over the 18-week standard for procedures such as hysteroscopy, ablation or hysterectomy.
Privately, you can typically see a consultant within 3–7 days, with ultrasound or hysteroscopy within 1–2 weeks and any procedure within 2–6 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Tranexamic acid or anti-inflammatories. Non-hormonal tablets taken during your period that can reduce blood loss significantly.
- Hormonal coil (levonorgestrel IUS). Usually the most effective medical treatment, thinning the womb lining and often making periods very light.
- Contraceptive pill or progestogens. Regulate and lighten bleeding for women who prefer or need alternatives to the coil.
- Endometrial ablation. A short procedure that removes or destroys the womb lining, suitable for women who have completed their family.
- Hysterectomy. Definitive surgical removal of the womb for severe bleeding when other treatments have failed.
What does private treatment cost?
As a guide, a private hysteroscopy typically costs £1,800–£3,000, endometrial ablation £3,500–£5,500 and hysterectomy £7,000–£12,000, with an initial consultation and scan around £400–£700.
Does health insurance cover heavy periods (menorrhagia)?
Private medical insurance generally covers the investigation and treatment of heavy periods — including hysteroscopy, ablation and hysterectomy — where the problem began after your policy started. Long-standing heavy bleeding you saw a doctor about before joining would usually be excluded as pre-existing. Note that contraceptive-related costs, such as coil fitting purely for contraception, are typically not covered even when the same device treats bleeding.
Frequently asked questions
How heavy is too heavy for a period?
There is no need to measure blood loss precisely: if your periods regularly interfere with daily life, they count as heavy. Warning signs include changing protection every hour or two, flooding, passing clots larger than a 10p coin, bleeding beyond seven days, or symptoms of anaemia such as tiredness and breathlessness. Any of these justifies seeing a doctor — effective treatments exist.
Do heavy periods always mean something is wrong?
No. In many women no underlying abnormality is found, and the bleeding relates to hormonal factors alone — sometimes called dysfunctional bleeding. However, fibroids, polyps, adenomyosis and occasionally clotting or thyroid problems are common enough that investigation with blood tests and an ultrasound is worthwhile, particularly if bleeding has changed recently or you are over 45.
Will I need a hysterectomy?
Very probably not. Most women get good control with medical treatment — the hormonal coil is particularly effective, often reducing bleeding to very light levels within a few months. Endometrial ablation offers a less invasive surgical option for those who have completed their family. Hysterectomy remains available as a definitive cure, but it is now a last resort rather than a routine treatment.
Related guides
- Endometriosis
- Fertility Problems
- Ovarian Cysts
- Pelvic Organ Prolapse
- Polycystic Ovary Syndrome (PCOS)
- Uterine Fibroids