abnormal uterine bleeding (AUB) with medicines
has fewer risks but doesn't always work as well as surgical treatment. If you
plan to become pregnant in the future, or if you are nearing the time when your
menstrual periods will stop (menopause), you may want to try
Goals of medicine treatment
The goal of medicine
treatment for abnormal uterine bleeding is to reduce or eliminate blood
loss. This can be done in one or both of the following ways:
There are several hormone therapies for managing
abnormal uterine bleeding. These treatments help reduce bleeding and
regulate the menstrual cycle:
- Birth control pills (synthetic
estrogen and progesterone). Daily birth control pills
prevent pregnancy. They also reduce the amount of heavy menstrual bleeding by
about half.2 In other words, when you take birth
control pills, your menstrual bleeding can be half as heavy as it was before
you took the pills. But when you stop taking the pills, irregular bleeding or
perimenopausal symptoms may return.
- Progestin pills (synthetic
progesterone). In some women, progestins can control
endometrial growth and bleeding. You usually take progestins 10 to 12 days
levonorgestrel intrauterine device (IUD). A doctor
inserts this birth control device into your uterus through your vagina. It
stays in your body for up to 5 years and releases levonorgestrel, a form of
progesterone, into the uterus.
- Estrogen. In some severe or urgent cases, estrogen may
be used to reduce bleeding.
- Hormone suppressors such as
gonadotropin-releasing hormone analogues (GnRH-As).
GnRH-As are rarely used. These drugs reduce estrogen production, making
your body think it is in menopause. This reduces or stops menstrual periods for
as long as you take the medicine. Side effects with GnRH-As are common.
A medicine called tranexamic acid (such as Lysteda) is sometimes used for women who have bleeding that is heavier than normal. This medicine is not a hormone. It prevents bleeding by helping blood to clot. Talk to your doctor to find out if this option is right for you.
What to think about
estrogen therapy is typically used when severe blood loss
must be quickly stopped.