Abnormal uterine bleeding (AUB) can usually be
managed with medicine to reduce bleeding and/or hormone therapy to either stop
or regulate menstrual periods. Surgical treatment is reserved for bleeding that
can't be controlled with medicine or hormone therapy.
Acute, severe uterine bleeding
bleeding is usually treated on an emergency basis with a short course of
estrogen therapy. If that isn't effective in rare
dilation and curettage (D&C) may be done to clear
the uterus of tissue. When needed, a
blood transfusion is used to quickly restore needed
If you are treated for severe uterine bleeding, you
and your doctor can then choose a treatment that is safe for the
Ongoing uterine bleeding
Your age, the cause of
your condition, and any future plans for pregnancy will impact the treatment
choices available to you.
- If you are a teen, you
can expect your periods to become more regular as your body matures. You may
choose to wait and see if your periods become more regular. If you need
treatment, your doctor may prescribe
birth control pills to regulate your cycle.
- If you are not ovulating regularly, it's difficult to predict how long your
irregular bleeding will last until you stop having periods completely (menopause). If you need treatment, your doctor may
give you hormone therapy (such as birth control pills or a hormonal IUD) to regulate your
cycle. If you have no future childbearing plans and have severe symptoms, you
can opt for surgical treatment to remove your uterus (hysterectomy)
or to destroy the uterine lining (endometrial ablation).
- If you are ovulating regularly, have
irregular vaginal bleeding, and plan to become pregnant in the future, talk to
your doctor about your treatment options. He or she may recommend oral
progestin and/or birth control pills until your bleeding becomes more regular.
If you have no future pregnancy plans, you can consider endometrial ablation or
hysterectomy if other treatment doesn't help.
Gonadotropin-releasing hormone analogues (GnRH-As) are
rarely used now. 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. After you stop taking the medicine, your symptoms will come
back unless you are close to menopause. 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.
For more information about treatment options,
- Abnormal Uterine Bleeding: Should I Use Hormone Therapy?
What to think about
If you are thinking of getting treatment for
abnormal uterine bleeding, evaluate the following:
- Has irregular menstrual bleeding caused a
significant change in your lifestyle?
- Do you plan to become
pregnant in the future?
- Do you have anemia caused by irregular menstrual
- Do you want a treatment that will also provide birth
- Do you prefer to avoid medical treatment if
- Will you be starting menopause soon? If you are
approaching menopause, you can expect uterine bleeding to naturally stop
The answers to these questions will help you and your
doctor select the treatment plan that is best for you.