Treatments for heavy or prolonged menstrual bleeding

Treatments can be either medical or surgical.

Medical treatments:

Medical treatments can be divided into either hormonal or nonhormonal treatments.

Hormonal treatments:

use hormones that mimic those in your body, either a combination of oestrogen and progesterone or progesterone alone “oral contraceptive pills”

The most effective hormone method is the intrauterine device, which releases progesterone hormone into the local area of the lining of the uterus. It can stay in place in the uterus for up to 5 years.

Non-hormonal treatments:

aim to decrease blood flow and reduce cramping and pain. The most effective non-hormonal treatment is a drug called tranexamic acid, which allows the blood to clot more effectively.

Anti-inflammatory painkillers – these are also called nonsteroidal anti-inflammatory drugs (NSAIDs) –such as ibruprofen reduce menstrual flow by up to a quarter, but have no effect on the length of time the period lasts.

Surgical treatments:

Where medical management has not worked, there are several options to control bleeding:

Hysteroscopy:

Polyps and small fibroids can be removed at the time of a hysteroscopy examination.

Laparoscopy (Key-hole surgery) or open surgery:

Larger fibroids which are too big or in the wrong position to be removed by hysteroscopy can be removed using these surgical techniques.

Endometrial ablation:

This treatment involves using heat to destroy the lining of the uterus. It is only suitable if you do not plan to become pregnant. Endometrial ablation can be done as a day procedure, with most women returning to work the next day.

Hysterectomy:

This treatment involves an operation to remove the uterus via keyhole, vaginal or abdominal surgery. Hysterectomy is a permanent cure of heavy bleeding. It would be considered and is discussed when other treatment options have not been effective, are not suitable, or if this is the treatment you would prefer.