My periods are heavy. Not inconveniently heavy — medically heavy, the kind that my GP has documented and that I've been managing with a combination of hormonal treatment and high-absorbency disposable products for the past eight years. I've tried period underwear before. The light and medium absorbency options that most brands lead with are not designed for what I experience on my heaviest days, and I'd written off the category as not for me. The NIXI Body Carla Black Leakproof Knicker in Heavy absorbency is the product that changed that assessment, and I want to be specific about why the absorbency specification matters and why this one works.
The Heavy Period Problem
I want to be direct about this because I think heavy periods are underrepresented in period product marketing, which tends to focus on the average experience rather than the full range. A heavy period — clinically defined as losing more than 80ml per cycle — requires protection that most period underwear isn't designed to provide. Light and medium absorbency period underwear holds 10-15ml. On my heaviest days, I can lose that in an hour. The maths doesn't work, and the consequence of using the wrong absorbency is the kind of leak that makes you not want to leave the house.
The Carla Heavy holds up to 20ml — equivalent to 4 tampons — which is the absorbency that actually works for heavy flow days. That's the specification that made me try it, and the specification that made it work.
Finding the Carla Heavy
I found the NIXI Body Carla Black Leakproof Knicker in Heavy in the Women's Underpants collection on ALTOE. The NIXI Body brand was one I'd seen recommended specifically for heavy flow — their Carla range comes in light and heavy absorbency, which tells you the brand understands that periods are not one-size-fits-all. The collaboration with The Endometriosis Foundation was the detail that confirmed the brand takes women's health seriously. Endometriosis is one of the conditions most associated with heavy periods, and a brand that has designed its product in collaboration with the Foundation that supports people living with it is a brand that has done its research.
The black colourway was the practical choice for heavy flow days. Black is the colour that provides the confidence to wear period underwear on your heaviest days without anxiety about visible staining. The seamless waistband is the comfort feature that matters when you're already dealing with cramping and discomfort — the last thing you need is a waistband that digs. The VPL-free high leg design means these work under fitted clothing, which matters on the days when you want to feel normal rather than like you're managing a medical situation.
The First Heavy Day
I wore the Carla Heavy for the first time on the second day of my period — my heaviest day, the one I'd previously spent at home or close to a bathroom. I wore it alone, without any additional protection, which felt like a significant act of trust given my previous experiences with period underwear. I went to work. I had a full day of meetings. I came home.
No leaks. No anxiety. No awareness of wearing anything different from a normal pair of knickers. I'd spent eight years managing my heaviest days with a combination of products and anxiety, and the Carla Heavy replaced both of those things with a single pair of underwear. That's not a small thing. That's a day of my life back every month.
The Endometriosis Connection
I was diagnosed with endometriosis four years ago, which explained the severity of my periods and the pain that accompanies them. The seamless waistband on the Carla is specifically designed to be comfortable for people living with scars or stomas — a detail that reflects the brand's genuine engagement with the conditions that cause heavy periods rather than just the symptom. The £1 per pair donation to The Endometriosis Foundation is a concrete commitment to the community that needs this product most.
I mention this because I think it matters who designs a product and why. The Carla Heavy was designed in collaboration with people who understand endometriosis, and that understanding is visible in the details — the seamless waistband, the heavy absorbency, the black colourway. These are not accidental choices.
Six Months of Heavy Days
I now own six pairs of the Carla Heavy. I use them for my two heaviest days each cycle, rotating through the six pairs and washing between uses. The 30-degree machine wash has maintained the absorbency and the shape through six months of regular use. The black has not faded. The seamless waistband has not stretched. The four-layer gusset performs exactly as it did on day one.
I still use hormonal treatment to manage the severity of my periods. The Carla Heavy is not a replacement for medical management — it's a complement to it. But it's changed the experience of my heaviest days from something I dread and manage to something I get through without thinking about it, which is the most significant quality-of-life improvement I've had from a product in years.
My Recommendation
If your periods are heavy and you've tried period underwear before and found it insufficient, the NIXI Body Carla Black Leakproof Knicker in Heavy is the one to try. The 20ml absorbency is the specification that works for heavy flow. The black colourway is the right choice for confidence on difficult days. Size down as recommended. Wash at 30 degrees, air dry, no fabric conditioner.
You'll find it in the Women's Underpants and Lingerie collections, the Clothing range, and the broader Apparel & Accessories collection on ALTOE. Buy six pairs. Rotate them. Get your heavy days back.
— Rachel Okafor, NHS physiotherapist, endometriosis diagnosis four years ago, and person who went to work on her heaviest period day for the first time in eight years, London
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