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Treatments and drugs
By Mayo Clinic staffSpecific treatment for menorrhagia is based on a number of factors, including:
- Your overall health and medical history
- The cause and severity of the condition
- Your tolerance for specific medications, procedures or therapies
- The likelihood that your periods will become less heavy before long
- Your future childbearing plans
- Effects of the condition on your lifestyle
- Your opinion or personal preference
Drug therapy for menorrhagia may include:
- Iron supplements. If the condition is accompanied by anemia, your doctor may recommend that you take iron supplements regularly. If your iron levels are low but you're not yet anemic, you may be started on iron supplements rather than waiting until you become anemic.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin, others), help reduce menstrual blood loss. NSAIDs have the added benefit of relieving painful menstrual cramps (dysmenorrhea).
- Oral contraceptives. Aside from providing effective birth control, oral contraceptives can help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding.
- Oral progesterone. When taken for 10 or more days of each menstrual cycle, the hormone progesterone can help correct hormonal imbalance and reduce menorrhagia.
- The hormonal IUD (Mirena). This type of intrauterine device releases a type of progestin called levonorgestrel, which makes the uterine lining thin and decreases menstrual blood flow and cramping.
If you have menorrhagia from taking hormone medication, you and your doctor may be able to treat the condition by changing or stopping your medication.
You may need surgical treatment for menorrhagia if drug therapy is unsuccessful. Treatment options include:
- Dilation and curettage (D and C). In this procedure, your doctor opens (dilates) your cervix and then scrapes or suctions tissue from the lining of your uterus to reduce menstrual bleeding. Although this procedure is common and often treats menorrhagia successfully, you may need additional D and C procedures if menorrhagia recurs.
- Operative hysteroscopy. This procedure uses a tiny tube with a light (hysteroscope) to view your uterine cavity and can aid in the surgical removal of a polyp that may be causing excessive menstrual bleeding.
- Endometrial ablation. Using a variety of techniques, your doctor permanently destroys the entire lining of your uterus (endometrium). After endometrial ablation, most women have little or no menstrual flow. Endometrial ablation reduces your ability to become pregnant.
- Endometrial resection. This surgical procedure uses an electrosurgical wire loop to remove the lining of the uterus. Both endometrial ablation and endometrial resection benefit women who have very heavy menstrual bleeding. Like endometrial ablation, this procedure reduces your ability to become pregnant.
- Hysterectomy. Surgical removal of the uterus and cervix is a permanent procedure that causes sterility and cessation of menstrual periods. Hysterectomy is performed under anesthesia and requires hospitalization. Additional removal of the ovaries (bilateral oophorectomy) may cause premature menopause in younger women.
Except for hysterectomy, these surgical procedures are usually done on an outpatient basis. Although you may need a general anesthetic, it's likely that you can go home later on the same day.
When menorrhagia is a sign of another condition, such as thyroid disease, treating that condition usually results in lighter periods.
References
- Jurema M, et al. Menorrhagia. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- Excessive menstrual bleeding: Quick primer. National Women's Health Information Center. http://www.healthywomen.org/aub/pg1.html. Accessed April 25, 2009.
- Women and anemia — Heavy menstrual bleeding and fibroids. National Anemia Action Council. http://www.anemia.org/patients/featurearticles/content.php?contentid=000242§ionid=00015. Accessed April 25, 2009.
- Vaginal bleeding. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec18/ch242/ch242e.html. Accessed April 25, 2009.
- Abnormal uterine bleeding. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp095.cfm. Accessed April 25, 2009.
- Questions to ask about excessive menstrual bleeding. National Women's Health Information Center. http://www.healthywomen.org/aub/pg3.html. Accessed April 25, 2009.
- Menstrual periods fact sheet. The American College of Obstetricians and Gynecologists. Accessed April 25, 2009.
- Goodman A. Terminology and evaluation of abnormal uterine bleeding in premenopausal women. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- de Silva NK, et al. Definition and evaluation of abnormal uterine bleeding in adolescents. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- Lobo RA. Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Katz VL, et al., eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/133793247-3/834086474/1524/248.html#4-u1.0-B978-0-323-02951-3..50040-6_1192. Accessed April 25, 2009.
- Cervical cancer screening. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/cervical/basic_info/screening/. Accessed April 25, 2009.
- Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. April 29, 2009.
