Caroline Mansi, a 45-year-old mother and primary school teacher from Enfield, north London, endured five years of debilitating symptoms caused by cervical fibroids, including gushing bleeding and blood clots up to 10cm in diameter. The condition led to the breakdown of her relationship, forced her to keep spare clothes at work, and left her feeling she had “no freedom.” After a pioneering treatment called Sonata, she says she got her life back “overnight.”
Unpredictable and Debilitating Symptoms
Caroline’s symptoms began in 2017 when she was 36, starting with heavier periods that progressed to bleeding between periods and passing increasingly large clots. “The worst symptom that I had was extreme flooding, it was completely unpredictable,” she said. She always wore pads and carried a change of clothes everywhere, including at her school where her classroom was opposite the toilet for easy access. “Every chair I sat on ended up with some kind of stain on it. Obviously, it's mortifying,” she added.
The unpredictability restricted her life severely. She often had to leave work to shower and change. “I couldn't carry on my life as normal,” she said. In 2021, her relationship of five years ended due to the impact of her illness. “There was no possibility for any kind of sex life… I was bleeding constantly,” she explained.
Failed Treatments and Diagnosis
After visiting her GP in 2018, Caroline tried medroxyprogesterone, which worsened her symptoms. A hormonal IUD was also inserted, but her body expelled it when she passed a large clot through her cervix. In 2019, while on a forest walk with her sister, the IUD expelled itself, leading to a trip to A&E where she begged for a gynaecology referral. Due to the Covid pandemic, she did not see a gynaecologist until 2021, who diagnosed her with cervical fibroids—non-cancerous growths that caused her severe symptoms because of their location.
Her doctor recommended a full hysterectomy as the most effective option. Although she was in her late 30s and had only one child, she was so desperate that she insisted on the surgery. “I was on antidepressants because of how low I was. My relationship had broken down completely. I had no quality of life,” she said.
Pioneering Sonata Procedure
In December 2022, Caroline’s care was transferred to consultant gynaecologist Mr Mahantesh Karoshi at Chase Farm Hospital, part of the Royal Free London NHS Foundation Trust. He introduced her to the Sonata procedure, a minimally invasive treatment that uses radiofrequency energy to ablate fibroids under local anaesthetic. The procedure was newly available in the UK. “The most pain I had through the whole experience was the injection that I had for the local anaesthetic,” Caroline recalled. The procedure took about 20 minutes, with eight medical professionals present due to its novelty.
After the treatment, Caroline did not have a period for six months. When they returned, they were “normal”—four to five days, no clots, and not particularly heavy. “My symptoms went overnight,” she said. “I can swim, I can go to the gym, I can take my dogs for walks in the park without having to go to A&E that night. I don't have to have my classroom right opposite the toilet. Literally, I got my life back that day.”
