Materiały źródłowe

• #1 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  Menorrhagia or heavy menstrual bleeding is a common disorder among people who menstruate. It refers to bleeding lasting longer than seven days and involves bleeding more than is typical during menstruation. Talk to your provider about treatment options if heavy bleeding during your period affects your quality of life. […] Contact a healthcare provider if any of these scenarios apply to you. They can evaluate your symptoms and figure out whats causing you to have heavy periods. Then, they can recommend treatment options to manage heavy blood flow during your period. […] Treatment depends on whats causing your bleeding, how severe your bleeding is, your health, age and medical history. […] Talk with your provider about your health concerns and your goals for treatment so they can recommend the best approach.

• #2 Medical management of heavy menstrual bleeding

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4728737/

  Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life. […] Herein, we discuss the various options currently available to women, including antifibrinolytics, nonsteroidal anti-inflammatory preparations, oral contraceptive pills and oral, injectable and intrauterine progestogens. […] Effective medical management of heavy menstrual bleeding (HMB) relies on excellent communication between a woman and her doctor. […] Various medical treatment options are available, but many women proceed to surgery due to treatment failure or hormonal side effects. […] This review aims to provide a practical guide to well-established medical treatments for HMB. […] Nonhormonal options are limited to tranexamic or mefenamic acid.

• #3 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line medical therapy in ovulatory menorrhagia. Studies show an average reduction of 20-46% in menstrual blood flow. NSAIDs reduce prostaglandin levels by inhibiting cyclooxygenase and decreasing the ratio of prostacyclin to thromboxane. […] Oral contraceptive pills (OCPs) are a popular first-line therapy for women who desire contraception in addition to management of abnormal uterine bleeding (AUB). Menstrual blood loss is reduced as effectively as NSAIDs secondary to endometrial atrophy. OCPs suppress pituitary gonadotropin release and thus ovulation. […] Progestin is the most frequently prescribed medication for menorrhagia likely because of its safety in the setting of other medical comorbidities and its efficacy. Therapy with this drug results in a significant reduction in menstrual blood flow when used alone.

• #4 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  Medicines for heavy menstrual bleeding may include: Nonsteroidal anti-inflammatory drugs, also called NSAIDs. NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), help reduce menstrual blood loss. NSAIDs may also make menstrual cramps less painful. […] Tranexamic acid (Lysteda) helps reduce menstrual blood loss. This medicine only needs to be taken at the time of bleeding. […] Aside from birth control, oral contraceptives can help regulate menstrual cycles and ease menstrual bleeding that is heavy or lasts a long time. […] The natural hormone progesterone can help fix hormone imbalance and reduce heavy menstrual bleeding. The synthetic form of progesterone is called progestin. […] This intrauterine device releases a type of progestin called levonorgestrel. It makes the uterine lining thin and reduces menstrual blood flow and cramping.

• #5 Heavy periods: Learn More – What are the treatment options for heavy periods? – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279293/

  There are various treatment options for women who have problems related to heavy periods, including medication, hormonal contraceptives and surgery. Knowing about the pros and cons of the different options can make it easier to choose a suitable treatment. […] Hormonal contraceptives like birth control pills or hormonal coils (IUDs) affect the menstrual cycle and lessen the amount of bleeding. If one of these doesn’t help, it is usually possible to try out another one that is used in a different way or has a different active ingredient in it. Sometimes surgery can help. […] Painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and diclofenac, are often used for the relief of period pain and cramps, and also for heavy periods. They not only reduce the pain, but can also lessen the bleeding somewhat.

• #6 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  Tranexamic acid (Lysteda) was the first nonhormonal product approved by the FDA (in November of 2009) for the treatment of heavy menstrual bleeding. It is a synthetic derivative of lysine that uses antifibrinolytic effects by inhibiting the activation of plasminogen to plasmin. Tranexamic acid has been shown to reduce bleeding by 30-55% in those with chronic AUB. […] Surgical management has been the standard of treatment in menorrhagia due to structural causes (eg, fibroids) or when medical therapy fails to alleviate symptoms. Surgical treatment ranges from a simple DC to a total hysterectomy. […] A DC should be used for diagnostic purposes. It is not used for treatment because it provides only short-term relief, typically 1-2 months, though can be used to stop acute bleeding episodes in specific circumstances.

• #7 Treatment with medication | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/periods/heavy-periods/treating-heavy-bleeding-with-medication

  The contraceptive pill releases substances that act like the natural hormones oestrogen and progesterone. […] The progestogen-only pill (POP or mini-pill) also works by stabilising the lining of the uterus. […] Tranexamic acid reduces bleeding by about 40 percent. […] NSAIDS reduce bleeding by about 30 percent. […] IUD reduces bleeding by about 95 percent after at least three months use. […] Oral contraceptive pill reduces bleeding by about 40 percent. […] POP or mini-pill reduces bleeding by about 85 percent.

• #8 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  Healthcare providers recommend medication before surgical treatment. Some possible options include: Iron supplements improve your iron levels. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin can ease your cramps and reduce your bleeding. Birth control (pills, vaginal ring, patch, IUDs) may help make your periods more regular and lighten your blood flow. Hormone replacement therapy (HRT) can help balance the amount of estrogen and progesterone in your body so that your menstrual flow isnt as heavy. HRT is often recommended for heavy menstrual bleeding associated with perimenopause but comes with risks that you should discuss with your provider. Gonadotropin-releasing hormone (GnRH) agonists and antagonists can temporarily stop or reduce bleeding. Desmopressin nasal spray (Stimate) can stop bleeding associated with von Willebrand disease by helping your blood clot. Antifibrinolytic medicines, like tranexamic acid, prevent clots from breaking down and causing excessive bleeding.

• #9 Heavy Menstrual Bleeding: Symptoms and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/heavy-menstrual-bleeding

  Hormone replacement therapy can balance estrogen and progesterone levels, potentially reducing heavy menstrual flow. It is also suitable for perimenopausal-related heavy bleeding. […] Antifibrinolytic medications, such as tranexamic acid, can swiftly slow menstrual bleeding by aiding the blood clotting system. […] Gonadotropin-releasing hormone (GnRH) agonists can temporarily halt or lessen bleeding by inhibiting ovulation. […] If one or more medications are not effective, doctors may suggest surgical treatments. […] In general, doctors recommend medications. […] If you plan for a pregnancy in the next few months, nonsteroidal anti-inflammatory drugs (NSAIDs) or antifibrinolytic medicines would be suitable. However, NSAIDs may not be as effective in addressing heavy menstrual bleeding compared to hormonal treatments.

• #10 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  If you have heavy menstrual bleeding from taking hormone medicine, you may need to stop or change your medicine. […] If you have anemia due to heavy menstrual bleeding, you may need to take iron supplements. If your iron levels are low but you’re not yet anemic, you may be started on iron supplements instead of waiting until you become anemic. […] You may need surgery for heavy menstrual bleeding if medicines do not help. Treatment options include: Dilation and curettage, also called a DC. In this procedure, your doctor opens your cervix. This also is called dilating the cervix. The doctor then scrapes or suctions tissue from the lining of your uterus. This also is known as curettage. […] The goal of this procedure is to block blood flow to uterine fibroids. Blocking blood flow to fibroids helps to shrink them.

• #11 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  Healthcare providers recommend medication before surgical treatment. Some possible options include: Iron supplements improve your iron levels. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin can ease your cramps and reduce your bleeding. Birth control (pills, vaginal ring, patch, IUDs) may help make your periods more regular and lighten your blood flow. Hormone replacement therapy (HRT) can help balance the amount of estrogen and progesterone in your body so that your menstrual flow isnt as heavy. HRT is often recommended for heavy menstrual bleeding associated with perimenopause but comes with risks that you should discuss with your provider. Gonadotropin-releasing hormone (GnRH) agonists and antagonists can temporarily stop or reduce bleeding. Desmopressin nasal spray (Stimate) can stop bleeding associated with von Willebrand disease by helping your blood clot. Antifibrinolytic medicines, like tranexamic acid, prevent clots from breaking down and causing excessive bleeding.

• #12 Treatment of Menorrhagia | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0615/p1813.html

  Menorrhagia is defined as excessive uterine bleeding occurring at regular intervals or prolonged uterine bleeding lasting more than seven days. […] The levonorgestrel-releasing intrauterine device is an effective therapy for women who want to preserve fertility and avoid surgery. […] Overall, hysterectomy and endometrial ablation result in the greatest satisfaction rates if future childbearing is not desired. Treatment of menorrhagia results in substantial improvement in quality of life. […] Oral progestogens are the most commonly prescribed therapy for menorrhagia. […] Oral progestin therapy for 21 continuous days (days 5 to 26 of the menstrual cycle) effectively reduces menstrual blood loss, but patient satisfaction is higher with the levonorgestrel-releasing IUD. […] Although used as a contraceptive, the levonorgestrel-releasing IUD produces significant reductions in menstrual blood loss.

• #13 Medical management of heavy menstrual bleeding

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4728737/

  Hormonal options include the levonorgestrel-releasing intrauterine system, the combined oral contraceptive pill or progestogen preparations. […] There is a clear unmet need for effective, acceptable medical treatments for HMB. Selective progesterone receptor modulators may provide a novel therapeutic option for these women in the future.

• #14 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  High-dose oral progestin options (eg, norethindrone 5-15 mg daily, medroxyprogesterone 5-30 mg daily) can be taken day 5 to 26 of the menstrual cycle or continuously and have shown to reduce blood loss by 80%. […] The levonorgestrel intrauterine system (IUD) reduces menstrual blood loss by as much as 97%. It is comparable to transcervical resection of the endometrium for reduction of menstrual bleeding. […] These agents are used on a short-term basis in selected patients due to high costs and severe adverse effects. GnRH agonists and antagonists can be effective in reducing menstrual blood flow. […] Danazol can effectively reduce heavy menstrual bleeding, though serious adverse effects limit its use. […] Estrogens are given intravenously every 4-6 hours in patients with acute bleeding. A DC procedure may be necessary if no response is noted in 24 hours.

• #15 Heavy Menstrual Bleeding | ACOG

  https://www.acog.org/womens-health/faqs/heavy-menstrual-bleeding

  Heavy menstrual bleeding is very common. About one third of women seek treatment for it. Heavy menstrual bleeding is not normal. It can disrupt your life and may be a sign of a more serious health problem. If you are worried that your menstrual bleeding is too heavy, tell your obstetrician-gynecologist (ob-gyn). […] Heavy menstrual bleeding may be a sign of an underlying health problem that needs treatment. Blood loss from heavy periods also can lead to a condition called iron-deficiency anemia. Severe anemia can cause shortness of breath and increase the risk of heart problems. […] Medications often are tried first to treat heavy menstrual bleeding: Heavy bleeding caused by problems with ovulation, endometriosis, PCOS, and fibroids often can be managed with certain hormonal birth control methods. Depending on the type, these methods can lighten menstrual flow, help make periods more regular, or even stop bleeding completely.

• #16 Mirena® (levonorgestrel-releasing intrauterine system) 52mg

  https://www.mirena-us.com/heavy-period-treatment

  Mirena is FDA-approved to treat heavy periods for up to 5 years in women who choose an IUD for birth control. […] Mirena IUD prevents pregnancy for up to 8 years, and also treats heavy periods for up to 5 years in women who choose an IUD for birth control. […] Mirena is highly effective at reducing heavy periods. […] A Mirena can reduce your heavy periods by thinning the lining of the uterus. In a clinical trial performed in women with heavy menstrual bleeding that were treated with Mirena, almost 9 out of 10 were treated successfully — with their blood loss reduced by more than half after 6 months. […] Mirena can reduce heavy periods for up to 5 years in women who chose an IUD for birth control. […] „Now that my heavy periods are reduced, I don’t need to wake up during the night to change my tampon” – Influencer Reneze (@sincerelyreneze) on using Mirena for birth control and for heavy menstrual bleeding treatment.

• #17 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  Medicines for heavy menstrual bleeding may include: Nonsteroidal anti-inflammatory drugs, also called NSAIDs. NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), help reduce menstrual blood loss. NSAIDs may also make menstrual cramps less painful. […] Tranexamic acid (Lysteda) helps reduce menstrual blood loss. This medicine only needs to be taken at the time of bleeding. […] Aside from birth control, oral contraceptives can help regulate menstrual cycles and ease menstrual bleeding that is heavy or lasts a long time. […] The natural hormone progesterone can help fix hormone imbalance and reduce heavy menstrual bleeding. The synthetic form of progesterone is called progestin. […] This intrauterine device releases a type of progestin called levonorgestrel. It makes the uterine lining thin and reduces menstrual blood flow and cramping.

• #18 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line medical therapy in ovulatory menorrhagia. Studies show an average reduction of 20-46% in menstrual blood flow. NSAIDs reduce prostaglandin levels by inhibiting cyclooxygenase and decreasing the ratio of prostacyclin to thromboxane. […] Oral contraceptive pills (OCPs) are a popular first-line therapy for women who desire contraception in addition to management of abnormal uterine bleeding (AUB). Menstrual blood loss is reduced as effectively as NSAIDs secondary to endometrial atrophy. OCPs suppress pituitary gonadotropin release and thus ovulation. […] Progestin is the most frequently prescribed medication for menorrhagia likely because of its safety in the setting of other medical comorbidities and its efficacy. Therapy with this drug results in a significant reduction in menstrual blood flow when used alone.

• #19 Heavy menstrual bleeding diagnosis and medical management | Contraception and Reproductive Medicine | Full Text

  https://contraceptionmedicine.biomedcentral.com/articles/10.1186/s40834-017-0047-4

  The treatment goal is to control the current episode of heavy bleeding and to reduce menstrual blood loss in subsequent cycles. […] The American College of Obstetricians and Gynecologists suggested that the selection of treatment for each woman depends on clinical stability, overall acuity, suspected etiology of bleeding, desired for future fertility and underlying medical problems. […] Oral combination hormonal contraceptives (CHCs) reduce menstrual blood loss and result in a consistent menstrual cycle interval. […] The only formula that has been approved for therapeutic indication of HMB by both the European Union and the United States Food and Drug Administration is a combination of estradiol valerate and dienogest. […] Progestin only regimens are safer alternatives for women with fewer contraindications compared to CHCs.

• #20 Causes and treatment of heavy menstrual bleeding – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/causes-and-treatment-of-heavy-menstrual-bleeding/

  Hormonal choices are more common: estrogen and progesterone combined in pill form, vaginal ring or a patch. […] When using the combined oral contraceptive pill, we recommend that you use at least a 30 microgram ethinyl estradiol and a monophasic pill, Dr. Huhmann said, offering Sprintec and Junel as examples with the monthly cycle or Seasonique every three months. […] Progesterone-only options include: Medroxyprogesterone (Provera), which is not a contraceptive, at 10 to 20 milligrams daily; Norethindrone acetate (Aygestin), which is not a contraceptive, at 5 to 10 milligrams daily. […] For patients who need contraception, but want to use a progesterone-only pill, 0.35 milligrams norethindrone (Micronor) or 4 milligrams drospirenone (Slynd) are options. […] Other options for contraception and menstrual regulation include medroxyprogesterone acetate (Depo-Provera), the Nexplanon etonogestrel implant or the levonorgestrel intrauterine device. […] The Nexplanon is associated with more irregular breakthrough bleeding that you’ll want to discuss with your patients, Dr. Huhmann said. You also may need to supplement with the progesterone-only pill with that implant in order to get better menstrual suppression.

• #21 Treatment of Menorrhagia | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0615/p1813.html

  Menorrhagia is defined as excessive uterine bleeding occurring at regular intervals or prolonged uterine bleeding lasting more than seven days. […] The levonorgestrel-releasing intrauterine device is an effective therapy for women who want to preserve fertility and avoid surgery. […] Overall, hysterectomy and endometrial ablation result in the greatest satisfaction rates if future childbearing is not desired. Treatment of menorrhagia results in substantial improvement in quality of life. […] Oral progestogens are the most commonly prescribed therapy for menorrhagia. […] Oral progestin therapy for 21 continuous days (days 5 to 26 of the menstrual cycle) effectively reduces menstrual blood loss, but patient satisfaction is higher with the levonorgestrel-releasing IUD. […] Although used as a contraceptive, the levonorgestrel-releasing IUD produces significant reductions in menstrual blood loss.

• #22 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  High-dose oral progestin options (eg, norethindrone 5-15 mg daily, medroxyprogesterone 5-30 mg daily) can be taken day 5 to 26 of the menstrual cycle or continuously and have shown to reduce blood loss by 80%. […] The levonorgestrel intrauterine system (IUD) reduces menstrual blood loss by as much as 97%. It is comparable to transcervical resection of the endometrium for reduction of menstrual bleeding. […] These agents are used on a short-term basis in selected patients due to high costs and severe adverse effects. GnRH agonists and antagonists can be effective in reducing menstrual blood flow. […] Danazol can effectively reduce heavy menstrual bleeding, though serious adverse effects limit its use. […] Estrogens are given intravenously every 4-6 hours in patients with acute bleeding. A DC procedure may be necessary if no response is noted in 24 hours.

• #23 Causes and treatment of heavy menstrual bleeding – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/causes-and-treatment-of-heavy-menstrual-bleeding/

  Hormonal choices are more common: estrogen and progesterone combined in pill form, vaginal ring or a patch. […] When using the combined oral contraceptive pill, we recommend that you use at least a 30 microgram ethinyl estradiol and a monophasic pill, Dr. Huhmann said, offering Sprintec and Junel as examples with the monthly cycle or Seasonique every three months. […] Progesterone-only options include: Medroxyprogesterone (Provera), which is not a contraceptive, at 10 to 20 milligrams daily; Norethindrone acetate (Aygestin), which is not a contraceptive, at 5 to 10 milligrams daily. […] For patients who need contraception, but want to use a progesterone-only pill, 0.35 milligrams norethindrone (Micronor) or 4 milligrams drospirenone (Slynd) are options. […] Other options for contraception and menstrual regulation include medroxyprogesterone acetate (Depo-Provera), the Nexplanon etonogestrel implant or the levonorgestrel intrauterine device. […] The Nexplanon is associated with more irregular breakthrough bleeding that you’ll want to discuss with your patients, Dr. Huhmann said. You also may need to supplement with the progesterone-only pill with that implant in order to get better menstrual suppression.

• #24 Patient education: Heavy periods (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/heavy-periods-beyond-the-basics

  Hormonal intrauterine device — There are IUDs that slowly release a hormone, progestin, into the uterus. […] Shot — Depot medroxyprogesterone acetate (brand name: Depo-Provera) is a long-acting form of a progesterone-like hormone, called a progestin. […] Antifibrinolytic medicines — Antifibrinolytic medicines, such as tranexamic acid (brand name: Lysteda), can help to slow menstrual bleeding quickly. […] Nonsteroidal anti-inflammatory drugs (NSAIDs) — Nonsteroidal anti-inflammatory drugs, such as ibuprofen (brand name: Motrin and Advil), naproxen (brand name: Aleve), and mefenamic acid (brand name: Ponstel), can help reduce menstrual bleeding and menstrual cramps. […] Gonadotropin-releasing hormone (GnRH) agonists — GnRH agonists are a type of medicine that can be used to temporarily reduce menstrual bleeding.

• #25 Heavy Periods (Menorrhagia): Causes and Treatment

  https://patient.info/womens-health/periods-and-period-problems/heavy-periods-menorrhagia

  Tranexamic acid tablets are an option if the LNG-IUS is not suitable or not wanted. Treatment with tranexamic acid can reduce the heaviness of bleeding by almost half in most cases. […] There are various types and brands. Some are available only on prescription but ibuprofen and naproxen are both available over the counter from pharmacies; mefenamic acid can only be prescribed. These medicines reduce the blood loss by about a quarter in most cases. […] This reduces bleeding by at least a third in most women. It often helps with period pain too. […] The contraceptive injection and the contraceptive implant also tend to reduce heavy periods. […] Norethisterone is a hormone (progestogen) medicine. It is not commonly used to treat heavy periods but it is sometimes considered if other treatments have not worked, are unsuitable or are not wanted.

• #26 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  High-dose oral progestin options (eg, norethindrone 5-15 mg daily, medroxyprogesterone 5-30 mg daily) can be taken day 5 to 26 of the menstrual cycle or continuously and have shown to reduce blood loss by 80%. […] The levonorgestrel intrauterine system (IUD) reduces menstrual blood loss by as much as 97%. It is comparable to transcervical resection of the endometrium for reduction of menstrual bleeding. […] These agents are used on a short-term basis in selected patients due to high costs and severe adverse effects. GnRH agonists and antagonists can be effective in reducing menstrual blood flow. […] Danazol can effectively reduce heavy menstrual bleeding, though serious adverse effects limit its use. […] Estrogens are given intravenously every 4-6 hours in patients with acute bleeding. A DC procedure may be necessary if no response is noted in 24 hours.

• #27 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  Healthcare providers recommend medication before surgical treatment. Some possible options include: Iron supplements improve your iron levels. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin can ease your cramps and reduce your bleeding. Birth control (pills, vaginal ring, patch, IUDs) may help make your periods more regular and lighten your blood flow. Hormone replacement therapy (HRT) can help balance the amount of estrogen and progesterone in your body so that your menstrual flow isnt as heavy. HRT is often recommended for heavy menstrual bleeding associated with perimenopause but comes with risks that you should discuss with your provider. Gonadotropin-releasing hormone (GnRH) agonists and antagonists can temporarily stop or reduce bleeding. Desmopressin nasal spray (Stimate) can stop bleeding associated with von Willebrand disease by helping your blood clot. Antifibrinolytic medicines, like tranexamic acid, prevent clots from breaking down and causing excessive bleeding.

• #28 Heavy Menstrual Bleeding: Symptoms and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/heavy-menstrual-bleeding

  Hormone replacement therapy can balance estrogen and progesterone levels, potentially reducing heavy menstrual flow. It is also suitable for perimenopausal-related heavy bleeding. […] Antifibrinolytic medications, such as tranexamic acid, can swiftly slow menstrual bleeding by aiding the blood clotting system. […] Gonadotropin-releasing hormone (GnRH) agonists can temporarily halt or lessen bleeding by inhibiting ovulation. […] If one or more medications are not effective, doctors may suggest surgical treatments. […] In general, doctors recommend medications. […] If you plan for a pregnancy in the next few months, nonsteroidal anti-inflammatory drugs (NSAIDs) or antifibrinolytic medicines would be suitable. However, NSAIDs may not be as effective in addressing heavy menstrual bleeding compared to hormonal treatments.

• #29 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  High-dose oral progestin options (eg, norethindrone 5-15 mg daily, medroxyprogesterone 5-30 mg daily) can be taken day 5 to 26 of the menstrual cycle or continuously and have shown to reduce blood loss by 80%. […] The levonorgestrel intrauterine system (IUD) reduces menstrual blood loss by as much as 97%. It is comparable to transcervical resection of the endometrium for reduction of menstrual bleeding. […] These agents are used on a short-term basis in selected patients due to high costs and severe adverse effects. GnRH agonists and antagonists can be effective in reducing menstrual blood flow. […] Danazol can effectively reduce heavy menstrual bleeding, though serious adverse effects limit its use. […] Estrogens are given intravenously every 4-6 hours in patients with acute bleeding. A DC procedure may be necessary if no response is noted in 24 hours.

• #30 Heavy menstrual bleeding – Wikipedia

  https://en.wikipedia.org/wiki/Heavy_menstrual_bleeding

  Heavy menstrual bleeding (HMB), previously known as menorrhagia or hematomunia, is a menstrual period with excessively heavy flow. It is a type of abnormal uterine bleeding (AUB). […] Treatment depends on the cause, severity, and interference with quality of life. Initial treatment often involves birth control pills. Tranexamic acid, danazol, hormonal intrauterine device, and painkillers (NSAIDs) are also helpful. […] The first line treatment option for those with HMB and no identified pathology, fibroids less than 3 cm in diameter, and/or suspected or confirmed adenomyosis is the levonorgestrel-releasing intrauterine system (LNG-IUS). Clinical trial evidence suggests that the LNG-IUS may be better than other medical therapy in terms of HMB and quality of life. […] Tranexamic acid treatments, which reduce bleeding by inhibiting the clot-dissolving enzymes, appear to be more effective than anti-inflammatory treatment like NSAIDs, but are less effective than LNG-IUS. Tranexamic acid tablets may reduce loss by up to 50%.

• #31 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  High-dose oral progestin options (eg, norethindrone 5-15 mg daily, medroxyprogesterone 5-30 mg daily) can be taken day 5 to 26 of the menstrual cycle or continuously and have shown to reduce blood loss by 80%. […] The levonorgestrel intrauterine system (IUD) reduces menstrual blood loss by as much as 97%. It is comparable to transcervical resection of the endometrium for reduction of menstrual bleeding. […] These agents are used on a short-term basis in selected patients due to high costs and severe adverse effects. GnRH agonists and antagonists can be effective in reducing menstrual blood flow. […] Danazol can effectively reduce heavy menstrual bleeding, though serious adverse effects limit its use. […] Estrogens are given intravenously every 4-6 hours in patients with acute bleeding. A DC procedure may be necessary if no response is noted in 24 hours.

• #32 Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/management-of-acute-abnormal-uterine-bleeding-in-nonpregnant-reproductive-aged-women

  ABSTRACT: Initial evaluation of the patient with acute abnormal uterine bleeding should include a prompt assessment for signs of hypovolemia and potential hemodynamic instability. […] Medical management should be the initial treatment for most patients, if clinically appropriate. Options include intravenous conjugated equine estrogen, multi-dose regimens of combined oral contraceptives or oral progestins, and tranexamic acid. […] Once the acute bleeding episode has been controlled, transitioning the patient to long-term maintenance therapy is recommended. […] The two main objectives of managing acute AUB are: 1) to control the current episode of heavy bleeding and 2) to reduce menstrual blood loss in subsequent cycles. Medical therapy is considered the preferred initial treatment. […] Hormonal management is considered the first line of medical therapy for patients with acute AUB without known or suspected bleeding disorders. Treatment options include IV conjugated equine estrogen, combined oral contraceptives (OCs), and oral progestins.

• #33 Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/management-of-acute-abnormal-uterine-bleeding-in-nonpregnant-reproductive-aged-women

  ABSTRACT: Initial evaluation of the patient with acute abnormal uterine bleeding should include a prompt assessment for signs of hypovolemia and potential hemodynamic instability. […] Medical management should be the initial treatment for most patients, if clinically appropriate. Options include intravenous conjugated equine estrogen, multi-dose regimens of combined oral contraceptives or oral progestins, and tranexamic acid. […] Once the acute bleeding episode has been controlled, transitioning the patient to long-term maintenance therapy is recommended. […] The two main objectives of managing acute AUB are: 1) to control the current episode of heavy bleeding and 2) to reduce menstrual blood loss in subsequent cycles. Medical therapy is considered the preferred initial treatment. […] Hormonal management is considered the first line of medical therapy for patients with acute AUB without known or suspected bleeding disorders. Treatment options include IV conjugated equine estrogen, combined oral contraceptives (OCs), and oral progestins.

• #34 Causes and treatment of heavy menstrual bleeding – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/causes-and-treatment-of-heavy-menstrual-bleeding/

  Hormonal and nonhormonal options are available to treat the cause of the bleeding. […] For acute treatment, the preferred therapy is a medroxyprogesterone (Provera) taper — 20 milligrams three times a day for seven days, followed by 20 milligrams daily for 21 days. This is preferred over the combined oral contraceptive pill taper due to risks of side effects from high estrogen dosing such as nausea, vomiting, mood changes and headaches. […] Long-term management starts with treating any underlying cause of the bleeding. Second, there are hormonal and nonhormonal options. Ibuprofen the night before the period and continuing through the first few days can reduce flow by up to 80%. Tranexamic acid, an off-label use for patients under 18, can be used for acute bleeding as well as long-term bleeding at up to 1,300 milligrams three times per day for five days.

• #35 Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/management-of-acute-abnormal-uterine-bleeding-in-nonpregnant-reproductive-aged-women

  Antifibrinolytic drugs, such as tranexamic acid, work by preventing fibrin degradation and are effective treatments for patients with chronic AUB. […] Once the acute episode of bleeding has been controlled, multiple treatment options are available for long-term treatment of chronic AUB. Effective medical therapies include the levonorgestrel intrauterine system, OCs (monthly or extended cycles), progestin therapy (oral or intramuscular), tranexamic acid, and nonsteroidal antiinflammatory drugs. […] The need for surgical treatment is based on the clinical stability of the patient, the severity of bleeding, contraindications to medical management, the patients lack of response to medical management, and the underlying medical condition of the patient. […] Hysterectomy, the definitive treatment for controlling heavy bleeding, may be necessary for patients who do not respond to medical therapy.

• #36 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  High-dose oral progestin options (eg, norethindrone 5-15 mg daily, medroxyprogesterone 5-30 mg daily) can be taken day 5 to 26 of the menstrual cycle or continuously and have shown to reduce blood loss by 80%. […] The levonorgestrel intrauterine system (IUD) reduces menstrual blood loss by as much as 97%. It is comparable to transcervical resection of the endometrium for reduction of menstrual bleeding. […] These agents are used on a short-term basis in selected patients due to high costs and severe adverse effects. GnRH agonists and antagonists can be effective in reducing menstrual blood flow. […] Danazol can effectively reduce heavy menstrual bleeding, though serious adverse effects limit its use. […] Estrogens are given intravenously every 4-6 hours in patients with acute bleeding. A DC procedure may be necessary if no response is noted in 24 hours.

• #37 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  This procedure shrinks fibroids by targeting and destroying fibroids through ultrasound waves and radiofrequency energy. It needs no incisions. […] This is the surgical removal of uterine fibroids. […] This procedure involves destroying the lining of the uterus. The process of destroying tissue also is known as ablation. […] The surgeon uses an electrosurgical wire loop to remove the lining of the uterus. Pregnancy isn’t recommended after this procedure. […] In this procedure, the uterus and cervix are removed. It ends menstrual periods and the ability to get pregnant. […] Sometimes heavy menstrual bleeding is a sign of another condition, such as thyroid disease. In those cases, treating the condition usually results in lighter periods.

• #38 Endometrial Ablation for Heavy Menstrual Bleeding | FDA

  https://www.fda.gov/medical-devices/surgery-devices/endometrial-ablation-heavy-menstrual-bleeding

  Endometrial ablation is a minimally invasive surgical procedure used to treat heavy menstrual bleeding (periods). The procedure works by ablating (destroying) the tissue in the lining of the uterus, which is called the endometrium. Because the endometrium is the tissue that causes bleeding, destroying this tissue may reduce menstrual bleeding to normal or lighter levels. […] The FDA has approved endometrial ablation devices for premenopausal patients with heavy menstrual bleeding due to benign (non-cancerous) causes for whom childbearing is complete. […] The main potential benefit of the procedure is the reduction in menstrual bleeding and improvement in quality of life. […] Endometrial ablation reduces menstrual bleeding to normal or lighter levels, but you may experience amenorrhea (lack of menstrual bleeding) following treatment.

• #39 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  Endometrial ablation is a surgical procedure that destroys the endometrium. For many, this procedure provides a minimally invasive and effective option for menorrhagia and can be used for acute uterine bleeding. […] Hysterectomy provides a definitive cure for menorrhagia, often utilized for people who do not desire future fertility and have failed medical and/or other surgical options.

• #40 In-Office Treatment of Menorrhagia (Heavy Periods) – MacArthur Medical Center

  https://macarthurmc.com/specialties/heavyperiods/

  Endometrial Ablation may be an alternative treatment option for pre-menopausal women with menorrhagia (excessive uterine bleeding) due to benign causes, for whom childbearing is complete. […] Endometrial ablation is a procedure to treat abnormal uterine bleeding. The procedure is intended to destroy all or most of the tissue that is responsible for menstrual bleeding (the endometrium). After the procedure, patients may never bleed again, or if they do, their bleeding is generally reduced. Not all patients experience a satisfactory reduction in bleeding so all treatment options should be discussed with your doctor. […] If heavy bleeding during your periods is affecting your quality of life and you believe your options are to wait until menopause or to have a hysterectomy, there may be other choices for help without major surgery.

• #41 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  If you have heavy menstrual bleeding from taking hormone medicine, you may need to stop or change your medicine. […] If you have anemia due to heavy menstrual bleeding, you may need to take iron supplements. If your iron levels are low but you’re not yet anemic, you may be started on iron supplements instead of waiting until you become anemic. […] You may need surgery for heavy menstrual bleeding if medicines do not help. Treatment options include: Dilation and curettage, also called a DC. In this procedure, your doctor opens your cervix. This also is called dilating the cervix. The doctor then scrapes or suctions tissue from the lining of your uterus. This also is known as curettage. […] The goal of this procedure is to block blood flow to uterine fibroids. Blocking blood flow to fibroids helps to shrink them.

• #42 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  Tranexamic acid (Lysteda) was the first nonhormonal product approved by the FDA (in November of 2009) for the treatment of heavy menstrual bleeding. It is a synthetic derivative of lysine that uses antifibrinolytic effects by inhibiting the activation of plasminogen to plasmin. Tranexamic acid has been shown to reduce bleeding by 30-55% in those with chronic AUB. […] Surgical management has been the standard of treatment in menorrhagia due to structural causes (eg, fibroids) or when medical therapy fails to alleviate symptoms. Surgical treatment ranges from a simple DC to a total hysterectomy. […] A DC should be used for diagnostic purposes. It is not used for treatment because it provides only short-term relief, typically 1-2 months, though can be used to stop acute bleeding episodes in specific circumstances.

• #43 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  If you have heavy menstrual bleeding from taking hormone medicine, you may need to stop or change your medicine. […] If you have anemia due to heavy menstrual bleeding, you may need to take iron supplements. If your iron levels are low but you’re not yet anemic, you may be started on iron supplements instead of waiting until you become anemic. […] You may need surgery for heavy menstrual bleeding if medicines do not help. Treatment options include: Dilation and curettage, also called a DC. In this procedure, your doctor opens your cervix. This also is called dilating the cervix. The doctor then scrapes or suctions tissue from the lining of your uterus. This also is known as curettage. […] The goal of this procedure is to block blood flow to uterine fibroids. Blocking blood flow to fibroids helps to shrink them.

• #44 Menorrhagia: Why Is My Period So Heavy?

  https://www.webmd.com/women/heavy-period-causes-treatments

  If your menstrual flow is still painful or the heavy bleeding is interrupting your lifestyle after trying medication, your doctor may recommend one of several kinds of medical procedures. […] […] Ultrasound. Your doctor may be able to target and shrink fibroids by using ultrasound waves. […] […] Uterine artery embolization. With this procedure, your doctor will put a catheter in an artery in your leg. Through the catheter, they inject tiny beads that block the blood flow to, and shrink, fibroids. […] […] Surgery. If your doctor finds polyps or fibroids, you can have them shrunk or removed. This may stop the heavy bleeding. […] […] Dilation and curettage (DC). During a DC, your doctor will open, or dilate, your cervix. Then, they will suction or scrape some of the tissue from the outermost layer of the lining of your uterus. The procedure often stops heavy periods, but some women need to get this done more than once. A DC may also be used to tell your doctor what is causing your heavy periods. […]

• #45 Menorrhagia Symptoms, Causes, & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/menorrhagia

  A nasal spray that helps to stop bleeding caused by certain bleeding disorders. […] Helps to reduce bleeding. […] Helps to decrease menstrual blood loss and only needs to be taken during the time of bleeding. […] The cervix is dilated and tissue from the lining of the uterus is scraped or suctioned off to help reduce period blood flow. […] The uterine arteries are blocked and blood supply to the arteries is stopped in order to shrink any fibroids. […] Uses ultrasound waves to shrink fibroids by destroying the tissue, which helps to reduce period blood flow. […] A surgical removal of the fibroids, which can be done through open abdominal surgery, laparoscopically (several small incisions), or hysteroscopically (through the vagina and cervix). […] Uses a laser, radiofrequency, or heat to destroy the lining of the uterus.

• #46 Abnormal Uterine Bleeding: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/menometrorrhagia-abnormal-uterine-bleeding

  There are several procedures available to treat abnormal uterine bleeding. Some options your provider may offer include: Hysteroscopy. A procedure where your provider removes atypical structures in your uterus, like fibroids and polyps, Uterine artery embolization. A treatment that stops blood flow to fibroids, causing them to shrink, Myomectomy. A method of removing fibroids while keeping your uterus intact and preserving your ability to get pregnant in the future, Endometrial ablation. A procedure that destroys your uterine lining through the use of a laser, heat, electricity, microwave energy or freezing. You shouldnt have this procedure if you want to get pregnant in the future, Dilation and curettage (DC). A procedure to remove tissue from your uterus. A DC can be a diagnostic tool or a treatment for abnormal bleeding. Your provider can send the tissue to a lab for analysis, Hysterectomy. A surgery to permanently remove your uterus. It treats cancer or cancerous changes in your endometrium. You lose the ability to get pregnant after a hysterectomy.

• #47 Abnormal Uterine Bleeding: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/menometrorrhagia-abnormal-uterine-bleeding

  There are several procedures available to treat abnormal uterine bleeding. Some options your provider may offer include: Hysteroscopy. A procedure where your provider removes atypical structures in your uterus, like fibroids and polyps, Uterine artery embolization. A treatment that stops blood flow to fibroids, causing them to shrink, Myomectomy. A method of removing fibroids while keeping your uterus intact and preserving your ability to get pregnant in the future, Endometrial ablation. A procedure that destroys your uterine lining through the use of a laser, heat, electricity, microwave energy or freezing. You shouldnt have this procedure if you want to get pregnant in the future, Dilation and curettage (DC). A procedure to remove tissue from your uterus. A DC can be a diagnostic tool or a treatment for abnormal bleeding. Your provider can send the tissue to a lab for analysis, Hysterectomy. A surgery to permanently remove your uterus. It treats cancer or cancerous changes in your endometrium. You lose the ability to get pregnant after a hysterectomy.

• #48 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  If medication doesnt improve your symptoms, your provider may recommend a surgical procedure. The type of procedure they recommend depends on the cause of your bleeding. Some possible surgical options are: Hysteroscopy. This procedure can diagnose and treat heavy period bleeding. It involves your provider using a thin, lighted tube to see inside your uterus. They can then use surgical tools to remove polyps or other causes of bleeding. Dilation and curettage (DC). A procedure that removes the outermost layer of the lining of your uterus. Your provider can send the tissue to a lab to see whats causing the bleeding. Myomectomy. A procedure that removes fibroids from your uterus. Uterine artery embolization (UAE). A procedure that restricts the blood flow from fibroids and tumors. Endometrial ablation. A procedure that destroys all or part of the lining of your uterus. Hysterectomy. Surgery that removes your uterus and prevents you from having periods or getting pregnant. […] If you think you have menorrhagia, its important to see a healthcare provider to treat it. […] With proper treatment and assistance from your provider, you can manage heavy periods without compromising your well-being.

• #49 Treatment of Menorrhagia | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0615/p1813.html

  Ablation methods (transcervical resection and balloon ablation) resulted in greater reductions of mean menstrual blood loss and higher amenorrhea rates than the levonorgestrel-releasing IUD. […] Hysterectomy is a definitive treatment for menorrhagia, but there is risk of surgical morbidity and the economic cost is high. […] Although endometrial resection procedures result in faster return to normal activities than hysterectomy, they are associated with a reintervention rate of up to 22 percent, so the cost difference between hysterectomy and endometrial resection narrows over time. […] It is important to ask women about the amount of menstrual bleeding and level of fertility they will accept before any treatment recommendations are made. […] Women who tolerate menstrual bleeding and wish to maintain fertility can try medical therapy with continuous progestin on days 5 to 26 of the menstrual cycle.

• #50 Abnormal Uterine Bleeding in Premenopausal Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0401/p435.html

  The 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is more effective than other medical therapies for reducing heavy menstrual bleeding. […] Hysterectomy is the most effective treatment for reducing heavy menstrual bleeding. […] Among medical therapies, the 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is most effective for decreasing heavy menstrual bleeding (71% to 95% reduction in blood loss) and performs similarly to hysterectomy when quality-adjusted life years are considered. […] To avoid surgical risks and preserve fertility, medical management is the first-line approach for most patients. Among medical therapies, the 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is most effective for decreasing heavy menstrual bleeding (71% to 95% reduction in blood loss) and is as effective as hysterectomy when quality-adjusted life years are considered. […] Hysterectomy is the definitive and most effective treatment for abnormal uterine bleeding, and it yields a high level of patient satisfaction.

• #51 Heavy menstrual bleeding – Wikipedia

  https://en.wikipedia.org/wiki/Heavy_menstrual_bleeding

  In the UK, NICE guidelines say that for individuals with HMB and no identified pathology or fibroids less than 3 cm in diameter who do not wish to have pharmacological treatment and who do not want to conserve their fertility, surgical options could be considered as a first-line treatment option. Options include a hysterectomy and second generation endometrial ablation, with hysterectomy being more effective than second generation endometrial ablation. […] A definitive treatment for heavy menstrual bleeding is to perform hysterectomy (removal of the uterus). The risks of the procedure have been reduced with measures to minimize the risk of deep vein thrombosis after surgery, and the switch from the front abdominal to vaginal approach greatly minimizing the discomfort and recuperation time for the patient; however extensive fibroids may make the womb too large for removal by the vaginal approach.

• #52 Heavy Menstrual Bleeding (Menorrhagia) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/heavy-menstrual-bleeding-menorrhagia

• #53 Which is the best treatment for heavy menstrual bleeding? | Cochrane

  https://www.cochrane.org/CD013180/MENSTR_which-best-treatment-heavy-menstrual-bleeding

  Evidence suggests that the levonorgestrel-releasing intrauterine system (LNG-IUS) is the best first-line option for reducing menstrual bleeding, while antifibrinolytics are probably the second best, and long-cycle progestogens are the third best. […] For second-line treatments, evidence suggests any type of hysterectomy is the best treatment for reducing bleeding, even though this is a major surgery, and resectoscopic endometrial ablation (REA) and non-resectoscopic endometrial ablation (NREA) are second and third best. […] Evidence suggests that minimally invasive hysterectomy results in a large increase in satisfaction, and NREA increases satisfaction, but we are uncertain of the true effect of the remaining interventions. […] Evidence suggests LNG-IUS is the best first-line treatment for reducing menstrual blood loss (MBL); antifibrinolytics are probably the second best, and long-cycle progestogens are likely the third best.

• #54 Abnormal Uterine Bleeding in Premenopausal Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0401/p435.html

  The 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is more effective than other medical therapies for reducing heavy menstrual bleeding. […] Hysterectomy is the most effective treatment for reducing heavy menstrual bleeding. […] Among medical therapies, the 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is most effective for decreasing heavy menstrual bleeding (71% to 95% reduction in blood loss) and performs similarly to hysterectomy when quality-adjusted life years are considered. […] To avoid surgical risks and preserve fertility, medical management is the first-line approach for most patients. Among medical therapies, the 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is most effective for decreasing heavy menstrual bleeding (71% to 95% reduction in blood loss) and is as effective as hysterectomy when quality-adjusted life years are considered. […] Hysterectomy is the definitive and most effective treatment for abnormal uterine bleeding, and it yields a high level of patient satisfaction.

• #55 Treatment with medication | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/periods/heavy-periods/treating-heavy-bleeding-with-medication

  The contraceptive pill releases substances that act like the natural hormones oestrogen and progesterone. […] The progestogen-only pill (POP or mini-pill) also works by stabilising the lining of the uterus. […] Tranexamic acid reduces bleeding by about 40 percent. […] NSAIDS reduce bleeding by about 30 percent. […] IUD reduces bleeding by about 95 percent after at least three months use. […] Oral contraceptive pill reduces bleeding by about 40 percent. […] POP or mini-pill reduces bleeding by about 85 percent.

• #56 Treatment with medication | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/periods/heavy-periods/treating-heavy-bleeding-with-medication

  The contraceptive pill releases substances that act like the natural hormones oestrogen and progesterone. […] The progestogen-only pill (POP or mini-pill) also works by stabilising the lining of the uterus. […] Tranexamic acid reduces bleeding by about 40 percent. […] NSAIDS reduce bleeding by about 30 percent. […] IUD reduces bleeding by about 95 percent after at least three months use. […] Oral contraceptive pill reduces bleeding by about 40 percent. […] POP or mini-pill reduces bleeding by about 85 percent.

• #57 Which is the best treatment for heavy menstrual bleeding? | Cochrane

  https://www.cochrane.org/CD013180/MENSTR_which-best-treatment-heavy-menstrual-bleeding

  Evidence suggests that the levonorgestrel-releasing intrauterine system (LNG-IUS) is the best first-line option for reducing menstrual bleeding, while antifibrinolytics are probably the second best, and long-cycle progestogens are the third best. […] For second-line treatments, evidence suggests any type of hysterectomy is the best treatment for reducing bleeding, even though this is a major surgery, and resectoscopic endometrial ablation (REA) and non-resectoscopic endometrial ablation (NREA) are second and third best. […] Evidence suggests that minimally invasive hysterectomy results in a large increase in satisfaction, and NREA increases satisfaction, but we are uncertain of the true effect of the remaining interventions. […] Evidence suggests LNG-IUS is the best first-line treatment for reducing menstrual blood loss (MBL); antifibrinolytics are probably the second best, and long-cycle progestogens are likely the third best.

• #58 Treatment with medication | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/periods/heavy-periods/treating-heavy-bleeding-with-medication

  The contraceptive pill releases substances that act like the natural hormones oestrogen and progesterone. […] The progestogen-only pill (POP or mini-pill) also works by stabilising the lining of the uterus. […] Tranexamic acid reduces bleeding by about 40 percent. […] NSAIDS reduce bleeding by about 30 percent. […] IUD reduces bleeding by about 95 percent after at least three months use. […] Oral contraceptive pill reduces bleeding by about 40 percent. […] POP or mini-pill reduces bleeding by about 85 percent.

• #59 Which is the best treatment for heavy menstrual bleeding? | Cochrane

  https://www.cochrane.org/CD013180/MENSTR_which-best-treatment-heavy-menstrual-bleeding

  For second-line treatments, evidence suggests hysterectomy is the best treatment for reducing bleeding, followed by REA and NREA. […] Minimally invasive hysterectomy may result in a large increase in satisfaction, and NREA also increases satisfaction, but we are uncertain of the true effect of the remaining second-line interventions. […] Evidence from 26 studies with 1770 participants suggests that LNG-IUS results in a large reduction of menstrual blood loss (MBL; mean rank 2.4, MD 105.71 mL/cycle, 95% CI 201.10 to 10.33; low certainty evidence); antifibrinolytics probably reduce MBL (mean rank 3.7, MD 80.32 mL/cycle, 95% CI 127.67 to 32.98; moderate certainty evidence); long-cycle progestogen reduces MBL (mean rank 4.1, MD 76.93 mL/cycle, 95% CI 153.82 to 0.05; low certainty evidence), and NSAIDs slightly reduce MBL (mean rank 6.4, MD 40.67 mL/cycle, 84.61 to 3.27; low certainty evidence; reference comparator mean rank 8.9).

• #60 Treatment with medication | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/periods/heavy-periods/treating-heavy-bleeding-with-medication

  The contraceptive pill releases substances that act like the natural hormones oestrogen and progesterone. […] The progestogen-only pill (POP or mini-pill) also works by stabilising the lining of the uterus. […] Tranexamic acid reduces bleeding by about 40 percent. […] NSAIDS reduce bleeding by about 30 percent. […] IUD reduces bleeding by about 95 percent after at least three months use. […] Oral contraceptive pill reduces bleeding by about 40 percent. […] POP or mini-pill reduces bleeding by about 85 percent.

• #61 Treatment with medication | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/periods/heavy-periods/treating-heavy-bleeding-with-medication

  The contraceptive pill releases substances that act like the natural hormones oestrogen and progesterone. […] The progestogen-only pill (POP or mini-pill) also works by stabilising the lining of the uterus. […] Tranexamic acid reduces bleeding by about 40 percent. […] NSAIDS reduce bleeding by about 30 percent. […] IUD reduces bleeding by about 95 percent after at least three months use. […] Oral contraceptive pill reduces bleeding by about 40 percent. […] POP or mini-pill reduces bleeding by about 85 percent.

• #62 Which is the best treatment for heavy menstrual bleeding? | Cochrane

  https://www.cochrane.org/CD013180/MENSTR_which-best-treatment-heavy-menstrual-bleeding

  For second-line treatments, evidence suggests hysterectomy is the best treatment for reducing bleeding, followed by REA and NREA. […] Minimally invasive hysterectomy may result in a large increase in satisfaction, and NREA also increases satisfaction, but we are uncertain of the true effect of the remaining second-line interventions. […] Evidence from 26 studies with 1770 participants suggests that LNG-IUS results in a large reduction of menstrual blood loss (MBL; mean rank 2.4, MD 105.71 mL/cycle, 95% CI 201.10 to 10.33; low certainty evidence); antifibrinolytics probably reduce MBL (mean rank 3.7, MD 80.32 mL/cycle, 95% CI 127.67 to 32.98; moderate certainty evidence); long-cycle progestogen reduces MBL (mean rank 4.1, MD 76.93 mL/cycle, 95% CI 153.82 to 0.05; low certainty evidence), and NSAIDs slightly reduce MBL (mean rank 6.4, MD 40.67 mL/cycle, 84.61 to 3.27; low certainty evidence; reference comparator mean rank 8.9).

• #63 Which is the best treatment for heavy menstrual bleeding? | Cochrane

  https://www.cochrane.org/CD013180/MENSTR_which-best-treatment-heavy-menstrual-bleeding

  For second-line treatments, evidence suggests hysterectomy is the best treatment for reducing bleeding, followed by REA and NREA. […] Minimally invasive hysterectomy may result in a large increase in satisfaction, and NREA also increases satisfaction, but we are uncertain of the true effect of the remaining second-line interventions. […] Evidence from 26 studies with 1770 participants suggests that LNG-IUS results in a large reduction of menstrual blood loss (MBL; mean rank 2.4, MD 105.71 mL/cycle, 95% CI 201.10 to 10.33; low certainty evidence); antifibrinolytics probably reduce MBL (mean rank 3.7, MD 80.32 mL/cycle, 95% CI 127.67 to 32.98; moderate certainty evidence); long-cycle progestogen reduces MBL (mean rank 4.1, MD 76.93 mL/cycle, 95% CI 153.82 to 0.05; low certainty evidence), and NSAIDs slightly reduce MBL (mean rank 6.4, MD 40.67 mL/cycle, 84.61 to 3.27; low certainty evidence; reference comparator mean rank 8.9).

• #64 Abnormal Uterine Bleeding in Premenopausal Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0401/p435.html

  The 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is more effective than other medical therapies for reducing heavy menstrual bleeding. […] Hysterectomy is the most effective treatment for reducing heavy menstrual bleeding. […] Among medical therapies, the 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is most effective for decreasing heavy menstrual bleeding (71% to 95% reduction in blood loss) and performs similarly to hysterectomy when quality-adjusted life years are considered. […] To avoid surgical risks and preserve fertility, medical management is the first-line approach for most patients. Among medical therapies, the 20-mcg-per-day formulation of the levonorgestrel-releasing intrauterine system (Mirena) is most effective for decreasing heavy menstrual bleeding (71% to 95% reduction in blood loss) and is as effective as hysterectomy when quality-adjusted life years are considered. […] Hysterectomy is the definitive and most effective treatment for abnormal uterine bleeding, and it yields a high level of patient satisfaction.

• #65 Which is the best treatment for heavy menstrual bleeding? | Cochrane

  https://www.cochrane.org/CD013180/MENSTR_which-best-treatment-heavy-menstrual-bleeding

  For second-line treatments, evidence suggests hysterectomy is the best treatment for reducing bleeding, followed by REA and NREA. […] Minimally invasive hysterectomy may result in a large increase in satisfaction, and NREA also increases satisfaction, but we are uncertain of the true effect of the remaining second-line interventions. […] Evidence from 26 studies with 1770 participants suggests that LNG-IUS results in a large reduction of menstrual blood loss (MBL; mean rank 2.4, MD 105.71 mL/cycle, 95% CI 201.10 to 10.33; low certainty evidence); antifibrinolytics probably reduce MBL (mean rank 3.7, MD 80.32 mL/cycle, 95% CI 127.67 to 32.98; moderate certainty evidence); long-cycle progestogen reduces MBL (mean rank 4.1, MD 76.93 mL/cycle, 95% CI 153.82 to 0.05; low certainty evidence), and NSAIDs slightly reduce MBL (mean rank 6.4, MD 40.67 mL/cycle, 84.61 to 3.27; low certainty evidence; reference comparator mean rank 8.9).

• #66 Which is the best treatment for heavy menstrual bleeding? | Cochrane

  https://www.cochrane.org/CD013180/MENSTR_which-best-treatment-heavy-menstrual-bleeding

  For second-line treatments, evidence suggests hysterectomy is the best treatment for reducing bleeding, followed by REA and NREA. […] Minimally invasive hysterectomy may result in a large increase in satisfaction, and NREA also increases satisfaction, but we are uncertain of the true effect of the remaining second-line interventions. […] Evidence from 26 studies with 1770 participants suggests that LNG-IUS results in a large reduction of menstrual blood loss (MBL; mean rank 2.4, MD 105.71 mL/cycle, 95% CI 201.10 to 10.33; low certainty evidence); antifibrinolytics probably reduce MBL (mean rank 3.7, MD 80.32 mL/cycle, 95% CI 127.67 to 32.98; moderate certainty evidence); long-cycle progestogen reduces MBL (mean rank 4.1, MD 76.93 mL/cycle, 95% CI 153.82 to 0.05; low certainty evidence), and NSAIDs slightly reduce MBL (mean rank 6.4, MD 40.67 mL/cycle, 84.61 to 3.27; low certainty evidence; reference comparator mean rank 8.9).

• #67 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  Menorrhagia or heavy menstrual bleeding is a common disorder among people who menstruate. It refers to bleeding lasting longer than seven days and involves bleeding more than is typical during menstruation. Talk to your provider about treatment options if heavy bleeding during your period affects your quality of life. […] Contact a healthcare provider if any of these scenarios apply to you. They can evaluate your symptoms and figure out whats causing you to have heavy periods. Then, they can recommend treatment options to manage heavy blood flow during your period. […] Treatment depends on whats causing your bleeding, how severe your bleeding is, your health, age and medical history. […] Talk with your provider about your health concerns and your goals for treatment so they can recommend the best approach.

• #68 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysterosonography (his-tur-o-suh-NOG-ruh-fee), you have a thin, flexible tube called a catheter placed in the uterus. Salt water, also called saline, is injected through the flexible tube into the hollow part of the uterus. An ultrasound probe transmits images of the inside of the uterus to a nearby monitor. […] During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #69 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  Menorrhagia or heavy menstrual bleeding is a common disorder among people who menstruate. It refers to bleeding lasting longer than seven days and involves bleeding more than is typical during menstruation. Talk to your provider about treatment options if heavy bleeding during your period affects your quality of life. […] Contact a healthcare provider if any of these scenarios apply to you. They can evaluate your symptoms and figure out whats causing you to have heavy periods. Then, they can recommend treatment options to manage heavy blood flow during your period. […] Treatment depends on whats causing your bleeding, how severe your bleeding is, your health, age and medical history. […] Talk with your provider about your health concerns and your goals for treatment so they can recommend the best approach.

• #70 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysterosonography (his-tur-o-suh-NOG-ruh-fee), you have a thin, flexible tube called a catheter placed in the uterus. Salt water, also called saline, is injected through the flexible tube into the hollow part of the uterus. An ultrasound probe transmits images of the inside of the uterus to a nearby monitor. […] During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #71 Menorrhagia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/255540-treatment

  Medical therapy for menorrhagia should be tailored to the individual. Factors taken into consideration when selecting the appropriate medical treatment include the patients clinical stability, acuity of bleeding, patient’s age, coexisting medical diseases and allergies, family history, and desire for fertility. Medication cost and adverse effects are also considered because they may play a direct role in patient compliance. Options for hormonal therapy include combined oral contraceptive pills, GnRH agonists and antagonists, hormonal patches or vaginal rings, progestin-only pills, depot medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine device, and the etonogestrel implant, according to American College of Obstetricians and Gynecologists. The Centers for Disease Control and Preventions Medical Eligibility Criteria for Contraceptive Use and US Food and Drug Administration (FDA) labeling information can be useful in determining the contraindications to hormonal methods based on medical comorbidities.

• #72 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysterosonography (his-tur-o-suh-NOG-ruh-fee), you have a thin, flexible tube called a catheter placed in the uterus. Salt water, also called saline, is injected through the flexible tube into the hollow part of the uterus. An ultrasound probe transmits images of the inside of the uterus to a nearby monitor. […] During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #73 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  Menorrhagia or heavy menstrual bleeding is a common disorder among people who menstruate. It refers to bleeding lasting longer than seven days and involves bleeding more than is typical during menstruation. Talk to your provider about treatment options if heavy bleeding during your period affects your quality of life. […] Contact a healthcare provider if any of these scenarios apply to you. They can evaluate your symptoms and figure out whats causing you to have heavy periods. Then, they can recommend treatment options to manage heavy blood flow during your period. […] Treatment depends on whats causing your bleeding, how severe your bleeding is, your health, age and medical history. […] Talk with your provider about your health concerns and your goals for treatment so they can recommend the best approach.

• #74 Heavy Menstrual Bleeding: Symptoms and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/heavy-menstrual-bleeding

  Hormone replacement therapy can balance estrogen and progesterone levels, potentially reducing heavy menstrual flow. It is also suitable for perimenopausal-related heavy bleeding. […] Antifibrinolytic medications, such as tranexamic acid, can swiftly slow menstrual bleeding by aiding the blood clotting system. […] Gonadotropin-releasing hormone (GnRH) agonists can temporarily halt or lessen bleeding by inhibiting ovulation. […] If one or more medications are not effective, doctors may suggest surgical treatments. […] In general, doctors recommend medications. […] If you plan for a pregnancy in the next few months, nonsteroidal anti-inflammatory drugs (NSAIDs) or antifibrinolytic medicines would be suitable. However, NSAIDs may not be as effective in addressing heavy menstrual bleeding compared to hormonal treatments.

• #75 Heavy Menstrual Bleeding: Symptoms and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/heavy-menstrual-bleeding

  If pregnancy consideration is far off in the future, hormonal birth control methods, a hormonal IUD, progestin pills, or injectable progestin may be viable options. […] If you decide against any future pregnancies, any of the above-mentioned medical treatments can be used. Among them, hormonal birth control (including the IUD) and antifibrinolytic medicines are likely the most effective. […] Preventing heavy menstrual bleeding may not always be possible. If you experience symptoms, it is advisable to seek guidance from your gynecologist for an accurate diagnosis and effective treatment to address your condition.

• #76 Heavy Menstrual Bleeding (Menorrhagia) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/heavy-menstrual-bleeding-menorrhagia

  Heavy menstrual bleeding may be a temporary or lifelong condition. Fortunately, there are many effective treatments for the condition. […] At Childrens Hospital of Philadelphia, adolescent medicine specialists are able to manage the majority of cases of heavy menstrual bleeding. However, if necessary, a coordinated approach may be used with specialists from gynecology, hematology, radiology and endocrinology and others to accurately diagnose and treat patients with heavy menstrual bleeding. […] Treatment for heavy menstrual bleeding will be recommended by your adolescent’s physician based on: Your adolescent’s age, overall health and medical history, Cause and severity of the condition, Your adolescent’s tolerance for specific medications, procedures or therapies, Your adolescents future childbearing plans, Effects of the condition on your adolescents lifestyle, Your adolescent’s opinion or preference.

• #77 Heavy Menstrual Bleeding Clinic – UChicago Medicine

  https://www.uchicagomedicine.org/comer/conditions-services/anemias-blood-diseases/conditions-services/heavy-menstrual-bleeding

  The Heavy Menstrual Bleeding Clinic is specifically designed to diagnose and treat menorrhagia (heavy menstrual bleeding) and blood disorders in adolescents and young adults up to age 24. […] At Comer Childrens Hospital at the University of Chicago Medicine, our specialists help patients and families understand when menstrual bleeding is a serious health concern, providing expert care to effectively manage the underlying condition and its symptoms. […] The treatment plan is different for each patient based on their medical history, diagnosis, symptoms and other important considerations. […] Options may include: Hormone therapy to regulate the menstrual cycle, including: Pills or patches, Injectable progesterone (Depo-Provera), Hormonal implants (intra-uterine devices or etonogestrel implants).

• #78 Heavy menstrual bleeding – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829

  Uterine fibroids may cause heavier than normal menstrual bleeding or bleeding that goes on for a long time. […] These small growths on the lining of the uterus may cause menstrual bleeding that is heavy or lasts for a long time. […] In this condition, glands from the lining of the uterus grow into the wall of the uterus itself. This can cause heavy bleeding and painful periods. […] Heavy menstrual bleeding can cause anemia related to blood loss. Anemia is a condition in which the body lacks enough red blood cells to carry oxygen to tissues. […] Along with heavy menstrual bleeding, you might have painful menstrual cramps. This also is known as dysmenorrhea. Talk to your doctor if your cramps make it hard to do your daily activities.

• #79 Heavy Menstrual Bleeding | ACOG

  https://www.acog.org/womens-health/faqs/heavy-menstrual-bleeding

  Heavy menstrual bleeding is very common. About one third of women seek treatment for it. Heavy menstrual bleeding is not normal. It can disrupt your life and may be a sign of a more serious health problem. If you are worried that your menstrual bleeding is too heavy, tell your obstetrician-gynecologist (ob-gyn). […] Heavy menstrual bleeding may be a sign of an underlying health problem that needs treatment. Blood loss from heavy periods also can lead to a condition called iron-deficiency anemia. Severe anemia can cause shortness of breath and increase the risk of heart problems. […] Medications often are tried first to treat heavy menstrual bleeding: Heavy bleeding caused by problems with ovulation, endometriosis, PCOS, and fibroids often can be managed with certain hormonal birth control methods. Depending on the type, these methods can lighten menstrual flow, help make periods more regular, or even stop bleeding completely.

• #80 Treatment of Menorrhagia | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0615/p1813.html

  Menorrhagia is defined as excessive uterine bleeding occurring at regular intervals or prolonged uterine bleeding lasting more than seven days. […] The levonorgestrel-releasing intrauterine device is an effective therapy for women who want to preserve fertility and avoid surgery. […] Overall, hysterectomy and endometrial ablation result in the greatest satisfaction rates if future childbearing is not desired. Treatment of menorrhagia results in substantial improvement in quality of life. […] Oral progestogens are the most commonly prescribed therapy for menorrhagia. […] Oral progestin therapy for 21 continuous days (days 5 to 26 of the menstrual cycle) effectively reduces menstrual blood loss, but patient satisfaction is higher with the levonorgestrel-releasing IUD. […] Although used as a contraceptive, the levonorgestrel-releasing IUD produces significant reductions in menstrual blood loss.

• #81 Heavy periods | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/periods/heavy-periods

  Heavy periods or heavy menstrual bleeding are common and affect around one in five Australian women. Some women with this condition also have a lot of pelvic pain. […] Heavy periods can impact enormously on some women’s day-to-day lives, but they can generally be managed using hormone therapies or surgery. […] If you are suffering with this condition, the best starting point is your GP. Your GP may refer you to a gynaecologist. Once the cause is known, your doctor can talk with you about your treatment options. […] Medication is usually the first treatment option recommended by doctors for heavy periods. […] If you have tried medication treatments for your heavy periods with no improvement, surgery may be your next option. […] Hormone releasing IUDs are more effective than the contraceptive pill and other medication for treating heavy or abnormal menstrual bleeding a review by Royal Women’s Hospital researchers has found.

• #82 Heavy periods | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/periods/heavy-periods

  Heavy periods or heavy menstrual bleeding are common and affect around one in five Australian women. Some women with this condition also have a lot of pelvic pain. […] Heavy periods can impact enormously on some women’s day-to-day lives, but they can generally be managed using hormone therapies or surgery. […] If you are suffering with this condition, the best starting point is your GP. Your GP may refer you to a gynaecologist. Once the cause is known, your doctor can talk with you about your treatment options. […] Medication is usually the first treatment option recommended by doctors for heavy periods. […] If you have tried medication treatments for your heavy periods with no improvement, surgery may be your next option. […] Hormone releasing IUDs are more effective than the contraceptive pill and other medication for treating heavy or abnormal menstrual bleeding a review by Royal Women’s Hospital researchers has found.

• #83 Treatment of Menorrhagia | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0615/p1813.html

  Menorrhagia is defined as excessive uterine bleeding occurring at regular intervals or prolonged uterine bleeding lasting more than seven days. […] The levonorgestrel-releasing intrauterine device is an effective therapy for women who want to preserve fertility and avoid surgery. […] Overall, hysterectomy and endometrial ablation result in the greatest satisfaction rates if future childbearing is not desired. Treatment of menorrhagia results in substantial improvement in quality of life. […] Oral progestogens are the most commonly prescribed therapy for menorrhagia. […] Oral progestin therapy for 21 continuous days (days 5 to 26 of the menstrual cycle) effectively reduces menstrual blood loss, but patient satisfaction is higher with the levonorgestrel-releasing IUD. […] Although used as a contraceptive, the levonorgestrel-releasing IUD produces significant reductions in menstrual blood loss.

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