If you’ve been diagnosed with menorrhagia, it’s very important that you get treated. Over time, heavy bleeding can lead to anemia because your red blood cells are low. They carry oxygen throughout your body.
The good news is there are many effective treatments for menorrhagia. Here’s a look at some of the most common options.
Hormonal Birth Control for Menorrhagia
If you don’t want to get pregnant, hormonal birth control is a good option. There are several choices:
Birth control pills. There are two kinds. Combined oral contraceptives contain both estrogen and progestin. It’s usually taken for 3 weeks, with a week off so that you can get your period. Research suggests they can cut the amount of blood you lose during your menstrual cycle in half. Your doctor may also recommend that you take the birth control pill continuously, or without a break. This keeps you from having a monthly period entirely.
The other kind of birth control pills are progestin-only pills. These are a popular option for women who can’t safely take estrogen. You take a pill every day, without breaks. It thins your uterine lining.
Birth control patch and ring. Like the combined birth control pill, these methods contain both estrogen and progestin. You wear the patch on your belly, butt, or back. The vaginal ring is inserted about once a month. How often you put it in and take it out depends on the manufacturer.
Hormonal IUDs (intrauterine devices). This type of IUD contains the hormone progestin. Like progestin-only pills, it thins the uterine lining to ward off bleeding. It can cause light bleeding or spotting as a side effect at first. This usually gets better after a few months. Research suggests it helps more than other hormonal options.
Depo-Provera shot. This is a shot of a long-acting form of progestin called depot medroxyprogesterone acetate. It’s given every 3 months. Like hormonal IUDs, it can trigger light bleeding at first.
Other Medications for Menorrhagia
There are other non-hormonal options to treat heavy menstrual bleeding. They include:
Tranexamic acid. This drug is a type of medicine known as an antifibrinolytic medicine. It helps your blood to clot. This slows menstrual bleeding down. It works fast, within a couple of hours. You take it as a pill each month at the start of your period. You only need to take it for a few days. It won’t impact your fertility. It does have potential side effects like headaches and muscle cramps. You may not be able to take this drug if you’re also using combination hormonal contraception like the birth control pill. It may raise your risk of blood clots, stroke, and heart attack.
Nonsteroidal anti-inflammatory drugs (NSAIDs). These are available over the counter and include aspirin, naproxen, and ibuprofen. Prescription medicines like mefenamic acid (Ponstel) are options, too. They lower levels of a hormone in your body known as prostaglandins. They can help ease heavy menstrual periods, but research shows they don’t work as well as other methods, like tranexamic acid or a hormonal IUD. Side effects are usually mild but can include problems with your gut, headache, and sleepiness.
Gonadotropin-releasing hormone (GnRH) agonists. These drugs stop your menstrual cycle completely, triggering temporary menopause. They’re used for short periods of less than 6 months. That’s because they can weaken bones when used longer. They’re usually only recommended if you’re waiting to have surgery. Side effects are similar to those of actual menopause and include hot flashes and vaginal dryness.
When to Consider Surgery
Sometimes, the above treatments aren’t enough. That’s especially true if you have fibroids or uterine polyps that cause heavy bleeding. In these cases, your doctor may recommend surgery. Options include:
Myomectomy. This surgery removes fibroids, but not your whole uterus. This way, you can still get pregnant if you want to.
Uterine artery embolization (UAE). The blood vessels to your uterus are blocked. This prevents blood flow to fibroids, which causes them to shrink.
MRI-guided ultrasound surgery. Ultrasound waves are used to destroy fibroids.
Endometrial ablation. This procedure destroys the uterine lining to stop or lessen bleeding. It can be used to treat fibroids, or for any woman who has heavy menstrual bleeding. It’s not recommended for women who still want to become pregnant.
Hysterectomy. This surgery removes the entire uterus. You won’t be able to get pregnant after the procedure. It may involve up to 6 weeks of recovery.
How Do I Figure Out Which Treatment Is Right for Me?
There are many treatments, but it can be hard to know the best one for you. Some questions to ask yourself include:
Do I want to get pregnant soon?
If you plan to try to conceive within a few months, you may want to try an NSAID or tranexamic acid to temporarily relieve symptoms. Just keep in mind that these may not work as well as some other methods.
Do I want to get pregnant eventually, but not right now?
A hormonal birth control method like the birth control pill, patch, or ring, the hormonal IUD, or a progestin shot may be the best option. This way, you can prevent pregnancy and ease bleeding with one medication.
Am I done with having children?
If you’re done or don’t want kids, any medical treatment will work. Hormonal birth control or tranexamic acid are most effective. The former also will help to prevent an unwanted pregnancy.
Have I tried some or all the drug options?
If the answer is yes, surgery may be your best bet.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
UpToDate: “Heavy or Prolonged Menstrual Bleeding (Menorrhagia),” “Patient Education: Fibroids.”
Women’s Health: “Medical Management of Heavy Menstrual Bleeding.”
Cochrane Library: “Combined Hormonal Contraceptives for Heavy Menstrual Bleeding.”
National Library of Medicine: “What Are the Treatment Options for Heavy Periods?”
American College of Obstetrics and Gynecology: “Abnormal Uterine Bleeding.”
