Materiały źródłowe

• #1 Menorrhagia (heavy menstrual bleeding): Causes and treatments

  https://www.medicalnewstoday.com/articles/295202

  Heavy menstrual bleeding is very common, and about one-third of females seek treatment for it. […] Treatments to reduce abnormally heavy bleeding depend on the underlying cause, but they can include hormonal birth control, hormonal therapy, and drugs that reduce the amount of bleeding. […] The treatment options for menorrhagia will depend on the individual case and the underlying cause of bleeding. […] Drug therapy options may include: iron supplements to treat anemia, birth control pills to make periods more regular, reduce bleeding, or stop bleeding completely, tranexamic acid (Lysteda), a prescription medication that a person takes each month at the time of bleeding to help reduce blood loss, hormone therapy with drugs containing estrogen, progesterone, or both to reduce the amount of bleeding, planting a hormonal IUD in the lining of the uterus, which can help reduce bleeding and cramping, medications that help treat the underlying cause of heavy menstrual bleeding. […] Several surgical procedures are available to relieve the symptoms of menorrhagia. […] A doctor will determine which, if any, surgical intervention is most appropriate. […] If bleeding interferes with daily life or emotional well-being, it is advisable to seek help from a doctor.

• #1 Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/09/screening-and-management-of-bleeding-disorders-in-adolescents-with-heavy-menstrual-bleeding

  Heavy menstrual bleeding at menarche and in adolescence may be an important sentinel for an underlying bleeding disorder. […] If obstetriciangynecologists suspect that a patient has a bleeding disorder, they should work in coordination with a hematologist for laboratory evaluation and medical management. […] Evaluation of adolescent girls who present with heavy menstrual bleeding should include assessment for anemia from blood loss, including serum ferritin, the presence of an endocrine disorder leading to anovulation, and evaluation for the presence of a bleeding disorder. […] The first-line approach to acute bleeding in the adolescent is medical management; surgery should be reserved for those who do not respond to medical therapy. […] Use of antifibrinolytics such as tranexamic acid or aminocaproic acid in oral and intravenous form may be used to stop bleeding.

• #1 Dilatation and curettage for heavy menstrual bleeding | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/non-urgent-elective-surgery/dilatation-and-curettage-for-heavy-menstrual-bleeding

  Do not offer dilatation and curettage as a treatment option for heavy menstrual bleeding. […] Treatment of heavy menstrual bleeding should not be initiated until the aetiology has been evaluated and premalignant or malignant disease excluded. […] The initial approach to heavy menstrual bleeding is usually pharmacological treatment, which can be hormonal or non-hormonal. Surgical approaches may be used where medical therapy is contraindicated or unsuccessful. Where pharmacological treatment has failed, there are several surgical options to control bleeding.

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

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

  Medication is usually the first treatment option that doctors recommend for heavy periods. […] Treatment with medication: […] can be very effective […] often has fewer and less serious side effects than other treatments […] does not affect your ability to have children or cause early menopause […] is suitable for many women. […] There are six types of medication used to treat heavy menstrual bleeding. […] Tranexamic acid helps your blood to clot, which will reduce the bleeding. […] Non-steroidal anti-inflammatory drugs (NSAIDs) reduce the amount of prostaglandin in the lining of your uterus, as prostaglandin seems to contribute to heavy bleeding and pain. […] Hormone-releasing intrauterine device (IUD) is a small, usually plastic device that sits inside your uterus and releases a small amount of progestogen (a drug that acts like the natural hormone progesterone). […] 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.

• #1 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.

• #1 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. Tranexamic acid (Lysteda) helps reduce menstrual blood loss. This medicine only needs to be taken at the time of bleeding. […] Oral contraceptives. Aside from birth control, oral contraceptives can help regulate menstrual cycles and ease menstrual bleeding that is heavy or lasts a long time. […] Oral progesterone. The natural hormone progesterone can help fix hormone imbalance and reduce heavy menstrual bleeding. The synthetic form of progesterone is called progestin. […] Hormonal IUD (Mirena, Liletta, others). This intrauterine device releases a type of progestin called levonorgestrel. It makes the uterine lining thin and reduces menstrual blood flow and cramping.

• #1 Menorrhagia Management

  https://mobile.fpnotebook.com/Gyn/Menses/MnrhgMngmnt.htm

  Reduces blood loss by 50% in women with heavy Menstrual Bleeding […] Progestin containing IUD (Mirena): Preferred option […] May reduce blood loss by 90% […] Tranexamic Acid (Lysteda) […] More effective than NSAIDs […] NSAIDs reduce Prostaglandin levels via cyclooxygenase inhibition […] Reduce menstrual flow by 20-46% […] Use NSAID for 3-5 days starting with Menses

• #1 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. […] 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.

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

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

  It is considered to be the most effective medical treatment for HMB as it induced a 70% reduction in MBL and PBAC scores during the first 3 months following insertion with a further reduction to 96% during the first year of use and continued efficacy for at least 4 years of treatment. […] Tranexamic acid is an anti-fibrinolytic drug that reduces blood loss given only with menstruation in women with HMB. […] Tranexamic acid significantly decreases endometrial tissue plasminogen activator activity, antigen and plasminogen activator inhibitor – type 1 antigen levels. […] Non-steroidal anti-inflammatory drugs (NSAIDs) reduce the inflammatory process by inhibiting the cyclooxygenase enzymes that synthesize prostaglandins. […] The most commonly used NSAIDs for HMB are mefenamic acid, ibuprofen, naproxen, meclofenamate and flurbiprofen taken at the onset of menstruation. […] These drugs were reported to reduce MBL for 1051% of women with HMB with a persisted effect up to 15 months. […] A surgical intervention should be considered for women who are anemic due to heavy bleeding or have failed one or two medical treatments.

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

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

  Antifibrinolytic medicines — Antifibrinolytic medicines, such as tranexamic acid (brand name: Lysteda), can help to slow menstrual bleeding quickly. These medicines work by helping the blood clotting system. […] 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. This treatment might be recommended for people who are waiting to have surgical treatment. […] If you have growths in your uterus, such as polyps or fibroids, getting treatment to remove them can reduce or eliminate heavy bleeding.

• #1 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. […] Anti-inflammatory painkillers reduce the blood loss by about a quarter in most cases. […] The combined oral contraceptive (COC) pill reduces bleeding by at least a third in most women. […] 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. […] Having surgery is not a first-line treatment but it can be an option if the above treatments do not help or are unsuitable. […] Some women have very heavy bleeding during a period. This can cause a lot of blood loss, and distress. One option as an emergency treatment is to take a course of norethisterone or medroxyprogesterone tablets.

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

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

  Some doctors and nurses advise people with heavy menstrual bleeding to take hormonal birth control continuously, without a break week. If you take this approach, you will not have monthly bleeding. This strategy is called „continuous dosing.” […] Progestin pills — Norethindrone acetate (brand name: Aygestin) or medroxyprogesterone acetate (brand name: Provera) pills are also an option. Progestin pills are sometimes recommended for people who do not ovulate regularly. They may be prescribed for use 5 to 14 days each month or continuously (every day). This treatment helps to make the lining of the uterus thinner, reducing or even eliminating bleeding. […] Hormonal intrauterine device — There are IUDs that slowly release a hormone, progestin, into the uterus. They do not contain estrogen.

• #1 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. […] Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter, or may stop.

• #1 How to stop heavy periods | Spire Healthcare

  https://www.spirehealthcare.com/health-hub/specialties/womens-health/how-to-stop-heavy-periods/

  You should see your GP urgently if you’re nearing menopause and have irregular, heavy periods or are past menopause and have vaginal bleeding. […] Your GP will work with you to put together a treatment plan that fits with your lifestyle and reduces your symptoms as much as possible. […] There is no evidence that changing your diet and taking supplements alone will reduce heavy bleeding during your periods. […] Staying hydrated can help maintain your blood volume. So make sure you drink four to six extra glasses of water each day of your period. […] In addition to dietary changes and home remedies, you can try over-the-counter medication for heavy menstrual bleeding. […] If you’ve tried medication for your heavy periods and it isn’t effective, your doctor may discuss surgical options with you.

• #1

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3644

  Yes, there are several lifestyle changes that can help reduce heavy menstrual bleeding. Here are some suggestions: Dietary Changes: Eating a well-balanced diet rich in iron and vitamins can help support overall health and reduce the severity of menstrual bleeding. Foods high in iron include red meat, poultry, fish, beans, and spinach. Exercise: Regular physical activity can help regulate your menstrual cycle and reduce the severity of menstrual bleeding. Aim for at least 30 minutes of moderate exercise most days of the week. Stress Management: Stress can contribute to hormonal imbalances that may worsen heavy menstrual bleeding. Practice stress-reducing techniques such as yoga, meditation, or deep breathing exercises. Maintain a Healthy Weight: Being overweight can contribute to hormonal imbalances and heavy menstrual bleeding. Maintaining a healthy weight through diet and exercise may help improve your symptoms. Limit Caffeine and Alcohol: Both caffeine and alcohol can contribute to dehydration and worsen menstrual symptoms. Limit your intake of these substances during your period. Stay Hydrated: Drinking plenty of water can help reduce bloating and water retention, which may help alleviate heavy menstrual bleeding. Herbal Remedies: Some herbal remedies, such as ginger, turmeric, and raspberry leaf tea, are thought to help reduce menstrual bleeding. However, it’s essential to speak with your healthcare provider before trying any herbal supplements, as they may interact with medications or have side effects. Acupuncture: Some women find that acupuncture helps reduce the severity of their menstrual symptoms, including heavy bleeding.

• #1 7 Ways To Combat Heavy Menstrual Bleeding – Raleigh-OBGYN

  https://raleighob.com/how-to-treat-heavy-menstrual-bleeding/

  Endometrial removal involves removing or thinning the endometrial lining to alleviate heavy bleeding. […] Dilation and curettage, or DC, removes tissue from the uterine lining in order to reduce menstrual bleeding. […] If you do not have the desire to get pregnant and your heavy menstrual bleeding persists, a hysterectomy may be an option. […] Although working out during your period may be the last thing on your mind, getting your body moving can help with menorrhagia.

• #1 Natural Treatment of Heavy Periods — Walnut Creek Naturopathic

  https://www.walnutcreeknaturopathic.com/blog/natural-treatment-of-heavy-periods

  Flavonoids and Vitamin C enhance capillary integrity, and have been shown to reduce menorrhagia in trials. […] Iron deficiency may cause the muscles of the uterus to weaken, thereby reducing the ability of these muscles to clamp down on blood vessels, which is necessary to decrease or stop bleeding. […] Research has shown that a deficiency in vitamin A impairs hormone production and enzyme activity in the ovaries of animals. […] Studies have shown that a deficiency in B vitamins causes the liver to lose its ability to inactivate estrogen, which could theoretically result in an estrogen excess. […] Vitamin K supplementation has also been shown to eliminate excessive menstrual loss in women without a known clotting disorder, so it may be wise to include this in a treatment plan. […] Menorrhagia is believed to be due to an altered prostaglandin-2 ratio and ginger has been shown to inhibit the enzymes related to this altered ratio: prostaglandin synthetase and cyclooxygenase. […] Hypothyroidism is a common cause of menorrhagia. […] If you or someone you know is experiencing menorrhagia, please seek a qualified health care provider to begin treatment for this condition.

• #1 Heavy Menstrual Bleeding: Symptoms and Treatment – HealthyWomen

  https://www.healthywomen.org/content/article/heavy-menstrual-bleeding-symptoms-and-treatment

  Heavy menstrual bleeding (called menorrhagia by health care professionals) is defined as soaking a pad and/or tampon every hour or less during each menstrual cycle. […] There are several options you may want to try to reduce your heavy menstrual bleeding. These include: Ice packs. Put an ice pack on your abdomen for 20 minutes at a time, several times a day when bleeding is especially heavy. […] Some research suggests low iron levels can increase menstrual bleeding, and that supplementing with the mineral can reduce menstrual bleeding. […] Most health care professional will recommend a medical therapy first before moving on to other, more invasive recommendations, if you have heavy menstrual bleeding and need relief. […] Oral contraceptives can reduce menstrual bleeding up to 60 percent by preventing ovulation and thinning the endometrium.

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

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

  You cant prevent many causes of abnormal uterine bleeding. But you can reduce your risk of certain conditions that lead to abnormal bleeding. For instance, maintaining a healthy weight plays a potential role in keeping your hormones in sync. Practicing safer sex (like wearing a condom) can reduce your risk of certain sexually transmitted infections (STIs) that can cause irregular uterine bleeding. […] Your treatment depends on whats causing your bleeding. Medications and surgical options are available to manage your bleeding or treat whats causing it. […] Medication is often the first treatment your healthcare provider will consider. Your provider may recommend the following medications for abnormal uterine bleeding: Birth control pills, Progestin (can be given by a shot, implant or IUD), Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin), Gonadotropin-releasing hormone (GnRH) agonists and antagonists can temporarily stop or reduce bleeding; they can also shrink the size of fibroids, Tranexamic acid, to treat heavy menstrual bleeding, Antibiotics, if the cause of bleeding is an infection, Iron supplements, if your provider is concerned about anemia.

• #1 Heavy Menstrual Periods Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/heavy-menstrual-periods/

  Sometimes doctors prescribe a medicine called tranexamic acid (such as Lysteda). It is not a hormone treatment. It reduces bleeding by helping blood to clot. […] You may want to think about surgery if medicines don’t help or if you have a growth in your uterus. Your choice will depend partly on whether you want to get pregnant in the future. […] If you have cramps during your periods, ask your doctor about taking an NSAID such as ibuprofen or naproxen. It can help with cramps and reduce menstrual bleeding. […] Your doctor may suggest that you take an iron supplement if your iron levels are low. You may be able to prevent anemia if you increase the amount of iron in your diet.

• #1 How to Stop Heavy Periods: 16 Diet Tips, Drugs, and Procedures

  https://www.healthline.com/health/how-to-stop-heavy-periods

  Making a few tweaks to your diet may ease your symptoms and get your menstrual cycle back on track. […] Consider making an appointment with a healthcare professional if you dont notice a change within one or two cycles. They may be able to prescribe medication to help control the bleeding and manage related symptoms. […] Increasing your intake of certain nutrients can help replenish what you lose during menstruation. […] Vitamin C may help reduce bleeding. It might also help your body absorb iron, which can help prevent anemia. […] Certain pain relievers can help manage blood loss, while hormonal therapies can help regulate your overall menstrual cycle. […] Hormonal birth control thins the uterine lining, typically resulting in less menstrual bleeding. […] Progestin tablets can help thin the uterine lining, which may reduce menstrual bleeding.

• #1 How to stop heavy periods | Spire Healthcare

  https://www.spirehealthcare.com/health-hub/specialties/womens-health/how-to-stop-heavy-periods/

  If your heavy periods are caused by fibroids in your womb, treatment may be non-invasive, using focused ultrasound to shrink your fibroids. […] If your heavy periods are not caused by fibroids in your womb, your doctor may recommend one of the following surgical procedures: […] There are several different prescription medications you can take to reduce heavy periods during the day and night you can discuss your options with your GP. […] Heavy bleeding can reduce your iron levels, which can cause anaemia. Vitamin C helps your body absorb iron.

• #1 How Can I Stop Prolonged Periods Naturally? 9 Natural Remedies

  https://www.medicinenet.com/how_can_i_stop_prolonged_periods_naturally/article.htm

  There are some home remedies that may help you treat heavy periods. Heavy periods require changing your pad or tampon every hour for at least two successive hours. […] Several natural remedies may help shorten or regulate menstrual cycles. Heavy periods may be a sign of some underlying health condition. You must consult your doctor if you get prolonged or heavy periods or if there is a sudden increase in blood loss during your periods. Quite often, heavy and prolonged periods may be a result of nutritional deficiencies. […] Managing stress through yoga, meditation, and deep breathing exercises can help regulate hormones and reduce the duration of your period. […] Physical activity can help regulate your menstrual cycle and reduce the duration of your periods. […] Eating a balanced diet that includes plenty of fresh fruits and vegetables, whole grains and lean protein can help regulate hormones and reduce the duration of your period.

• #1 Heavy Menstrual Bleeding in Adolescents: ACOG Management Recommendations | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0515/p633.html

  One in five adolescents with heavy menstrual bleeding has an underlying bleeding disorder. […] In hemodynamically stable adolescents with heavy menstrual bleeding, most bleeding can be stopped with high-dose estrogen oral contraceptives taken every six to eight hours, tranexamic acid, or high-dose progesterone. […] Long-term management of heavy menstrual bleeding is best achieved with continuous hormonal contraceptive therapies. […] A combination of hormonal and nonhormonal therapies may be necessary to control heavy menstrual bleeding in adolescent girls with bleeding disorders. Effective options include combined oral contraceptives with higher estrogen levels, the transdermal contraceptive patch, the vaginal contraceptive ring, and the levonorgestrel-releasing intrauterine device (Mirena), all of which can be used continuously with minimal or no withdrawal periods. […] An adolescent with a known bleeding disorder should be counseled before menarche and should have a plan in place for managing heavy menstrual bleeding.

• #1 Adolescent gynaecology – Heavy menstrual bleeding

  https://www.rch.org.au/clinicalguide/guideline_index/adolescent_gynaecology_menorrhagia/

  The most common cause of Heavy Menstrual Bleeding (HMB) in adolescents is anovulatory cycles […] Hormonal therapy aims to stabilise the endometrium […] Treatment is targeted to the underlying cause; for anovulatory bleeding, the objective is to stabilise the endometrium (oestrogen for initial haemostasis and progestins for extended endometrial stability) […] Consider non-hormonal management such as regular NSAIDs and tranexamic acid during menses […] Prophylactic treatment: Norethisterone 5-10 mg or medroxyprogesterone acetate 10 mg daily taken continuously […] Combined estrogen and progestin oral contraceptive pill: can decrease flow by 50% and is effective for anovulation or irregular menses. Often started with a low dose estrogen and moderate progestin […] Contraindications include (consider progesterone only): smoking, uncontrolled hypertension, cardiovascular disease, migraine with focal neurological signs, thrombosis risk.

• #1 Options for Prevention and Management of Menstrual Bleeding in Adolescent Patients Undergoing Cancer Treatment | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/01/options-for-prevention-and-management-of-menstrual-bleeding-in-adolescent-patients-undergoing-cancer-treatment

  Adolescents undergoing cancer treatment are at high risk of abnormal menstrual bleeding as a direct result of hematologic malignancies or as a secondary effect of chemotherapy, radiation therapy, or pretreatment regimens for stem cell or bone marrow transplantation. […] Therapy for both menstrual suppression and management of acute bleeding episodes should be tailored to the patient, the cancer diagnosis and treatment plan, and the individuals contraceptive needs. Because of the complex nature of cancer care, collaboration with the adolescents oncologist is highly recommended. […] Options for menstrual suppression include gonadotropin-releasing hormone (GnRH) agonists, progestin-only therapy, and combined hormonal contraception. […] Many of the methods for prophylactic or maintenance menstrual suppression also can provide contraception for this population; however, if a patient is treated with leuprolide acetate for menstrual suppression, this should not be considered a contraceptive method because ovulation may not be universally suppressed.

• #1 Managing Heavy Periods During Perimenopause: Understanding Your Treatment Options | Gynecology & Menopause Specialists located in Mount Pleasant, SC | Menopause Solutions

  https://www.menopausesolutions.org/post/managing-heavy-periods-during-perimenopause-understanding-your-treatment-options

  One common symptom experienced by women during perimenopause is heavy menstrual bleeding, also known as menorrhagia. Heavy periods can be characterized by prolonged bleeding, passing large blood clots, and needing to change sanitary products frequently. […] Hormonal contraceptives, including birth control pills, patches, and hormonal intrauterine devices (IUDs), can help regulate menstrual cycles and reduce the flow of blood during periods. […] Over-the-counter NSAIDs, such as ibuprofen or naproxen, can help alleviate menstrual cramps and reduce heavy bleeding by inhibiting prostaglandin production. […] This medication helps reduce heavy menstrual bleeding by preventing blood clots from breaking down. It is typically taken during menstruation to lessen the severity of bleeding. […] Progestin, a synthetic form of the hormone progesterone, can help regulate menstrual cycles and reduce heavy bleeding. It can be administered orally, as an injection, or as part of hormonal intrauterine devices.

• #1 Very Heavy Menstrual Flow – CemCOR

  https://www.cemcor.ubc.ca/resources/very-heavy-menstrual-flow

  The good news is that, in a large study of pre- and perimenopausal women, heavy flow was not caused by endometrial cancer. […] Heavy flow was most common and occurred in 20% of women ages 40-44. […] However higher estrogen with lower progesterone levels causes both heavy bleeding and the growth of fibroids. […] Early in perimenopause when cycles are regular, approximately 25% of women will have at least one heavy period. […] If your doctors appointment is delayed or you realize that you have had heavy flow for a number of cycles, start taking one over-the-counter tablet of iron (like 35 mg of ferrous gluconate) a day. […] Heavy bleeding is so common in perimenopause that when a woman over 40 is traveling or will be in a remote place, she should ask her doctor for a 16-day supply of 300 mg of oral micronized progesterone (or 10mg medroxyprogesterone tablets) to take with her. […] If flow is heavy in perimenopause progesterone will need to be taken daily for three months. […] Finally, a strong progestin-releasing IUD, Mirena has been shown to be effective for both heavy flow and for contraception.

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

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

  You cant prevent all causes of heavy period bleeding. But talking with your healthcare provider to get a diagnosis and treatment can help you manage your bleeding so that it doesnt interfere with your quality of life. […] Left untreated, heavy periods can interfere with your life. In addition, heavy menstrual bleeding can cause anemia and leave you feeling tired and weak. Other health problems can also arise if you dont get help. With proper treatment and assistance from your provider, you can manage heavy periods without compromising your well-being.

• #1 How to stop or manage heavy periods: Treatment and home remedies

  https://www.medicalnewstoday.com/articles/325965

  When a health issue is responsible for heavy periods, several treatments are available. […] Lifestyle strategies, products such as menstrual cups, supplements, and over-the-counter medications can all help with symptoms while a person works with their doctor to determine the best approach. […] Even when a person can manage their heavy flow, it is still best to consult a doctor, who will want to investigate and identify any underlying issues. This can help reduce the intensity and duration of the flow.

• #1 Women’s experiences of heavy menstrual bleeding and medical treatment: a qualitative study in primary care | British Journal of General Practice

  https://bjgp.org/content/73/729/e294

  Women advocated raising awareness of HMB. They suggested wider initiatives to get people talking about HMB, for example, with education in schools for boys and girls, in the workplace, and in the media. […] Tackling the enduring taboo and stigma of menstruation and HMB remains a major challenge for improving womens care. […] Wider societal strategies for raising awareness are needed, alongside specific informational resources so women are aware that assessment and treatment of HMB can be helpful and are empowered to seek it. […] For clinical practice, the findings emphasise the importance and value to women of patient-centred communication in this context.

• #1 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.

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

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

  How to prevent heavy menstrual bleeding? 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. […] Suitable treatment modalities depend on the cause and severity of heavy menstrual bleeding, age and medical history, body response to medications, and preferences. Your gynecologist can recommend options appropriate for your symptoms and pregnancy plan.

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

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

  Menorrhagia is the medical term for unusually heavy or long menstrual periods. Many women and people assigned female at birth (AFAB) have heavy flow days, and cramps are common during their period. But about 1 in 5 women deal with menorrhagia, or very heavy menstrual bleeding or bleeding for a full 7 days. […] If you soak through a pad or tampon every hour or so on a regular basis, talk with your doctor. They may be able to help. […] For most adolescents, surgery isn’t required to treat heavy period bleeding. Your doctor will usually prescribe a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen, to help with pain and reduce bleeding. They may also prescribe contraceptives, hormones, or tranexamic acid, which reduces blood loss during your period. […] Its always a good idea to talk with your doctor about your heavy periods, especially if the problem is new for you. It could lead to anemia (low levels of red blood cells), which can make you feel weak, tired, or out of breath.

• #2 Heavy menstrual bleeding. Tailoring treatment to the individual | Medicine Today

  https://medicinetoday.com.au/mt/2022/september/regular-series/heavy-menstrual-bleeding-tailoring-treatment-individual

  Once the results of initial investigations are known, the cause of HMB can often be determined. If investigations show an endometrial polyp, a submucosal fibroid or evidence of endometrial hyperplasia or carcinoma, prompt referral to a gynaecologist is needed for ongoing management. […] Long-term management of HMB depends on the cause and can be further subdivided into medical and surgical options. […] The use of medical treatments further depends on whether the woman requires contraception. […] Hormonal medications are the main treatments for HMB and may be considered if heavy bleeding persists after a few months of non-hormonal treatment or if preferred by the patient. […] Surgical management of HMB is indicated when a trial of available medical treatments has failed or when it is the individuals preference that a surgical solution is found. This requires appropriate referral to a gynaecologist.

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

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

  It is considered to be the most effective medical treatment for HMB as it induced a 70% reduction in MBL and PBAC scores during the first 3 months following insertion with a further reduction to 96% during the first year of use and continued efficacy for at least 4 years of treatment. […] Tranexamic acid is an anti-fibrinolytic drug that reduces blood loss given only with menstruation in women with HMB. […] Tranexamic acid significantly decreases endometrial tissue plasminogen activator activity, antigen and plasminogen activator inhibitor – type 1 antigen levels. […] Non-steroidal anti-inflammatory drugs (NSAIDs) reduce the inflammatory process by inhibiting the cyclooxygenase enzymes that synthesize prostaglandins. […] The most commonly used NSAIDs for HMB are mefenamic acid, ibuprofen, naproxen, meclofenamate and flurbiprofen taken at the onset of menstruation. […] These drugs were reported to reduce MBL for 1051% of women with HMB with a persisted effect up to 15 months. […] A surgical intervention should be considered for women who are anemic due to heavy bleeding or have failed one or two medical treatments.

• #2 Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/09/screening-and-management-of-bleeding-disorders-in-adolescents-with-heavy-menstrual-bleeding

  After correction of acute heavy menstrual bleeding, maintenance hormonal therapy can include combined hormonal contraceptives, oral and injectable progestins, and levonorgestrel-releasing intrauterine devices. […] Nonmedical procedures should be considered when there is a lack of response to medical therapy, if the patient is clinically unstable despite initial measures, or when severe heavy bleeding warrants further investigation, such as an examination under anesthesia. […] Obstetriciangynecologists can provide important guidance to premenarchal and postmenarchal girls and their families about issues related to menses and should counsel all adolescent patients with a bleeding disorder about safe medication use and future surgical considerations. […] Adolescents in whom a bleeding disorder has been diagnosed should be reminded that products that prevent platelet adhesion, such as aspirin or nonsteroidal antiinflammatory drugs, should be used only with the recommendation of a hematologist. […] In adolescents with known bleeding disorders, preoperative surgical evaluation, choice of hemostatic agents for control of intraoperative blood loss, and need for blood products should be determined in conjunction with a hematologist and an anesthesiologist.

• #2 Treatment of Menorrhagia | AAFP

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

  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. […] The levonorgestrel-releasing IUD is an effective long-term option if future childbearing is desired. […] Hysterectomy is a well-suited option for women who do not desire further childbearing or menstrual bleeding and are willing to assume the risk of surgery. […] However, if there is a desire to avoid major surgery, and childbearing is completed, endometrial ablation is a reasonable and effective alternative.

• #2 How Can I Stop Prolonged Periods Naturally? 9 Natural Remedies

  https://www.medicinenet.com/how_can_i_stop_prolonged_periods_naturally/article.htm

  Drink enough water to stay hydrated because menstrual fluid contains blood and water. […] Certain herbs, such as ginger, turmeric, and raspberry leaf, have anti-inflammatory properties that can help regulate hormones and reduce the duration of your period. […] Birth control can regulate hormones and reduce the duration of your period. Hormonal birth control methods, such as the pill, patch, and ring, can help regulate hormones and reduce the duration of your period. […] Pelvic floor exercises, such as Kegel exercises, can help strengthen the pelvic floor muscles and improve blood flow to the uterus, which can help reduce the duration of your period. […] Using a heating pad or soaking in a warm bath can help relieve menstrual cramps and shorten the duration of your period. […] May help reduce the duration of periods by regulating hormones and promoting blood flow. […] If you have heavy bleeding and prolonged periods, it would be best to consult a healthcare provider to rule out any underlying medical conditions.

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