It's important to let your doctor know if you have abnormal uterine bleeding. There are many ways to help treat it. Bleeding 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
Severe uterine bleeding is usually treated on an emergency basis with a short course of high-dose estrogen therapy. If that isn't effective in rare cases, a 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 blood volume.
If you are treated for severe uterine bleeding, you and your doctor can then choose a treatment that is safe for the longer term.
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 progestin or birth control pills to regulate your cycle.
- If you are not ovulating regularly, it's difficult to predict how long your abnormal 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 abnormal bleeding, and plan to become pregnant in the future, talk to your doctor about your treatment options. Depending on the cause of your bleeding, he or she may recommend treatments such as progestin or birth control pills or a hysteroscopy to remove polyps or fibroids. 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, see:
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 bleeding?
- Do you want a treatment that will also provide birth control?
- Do you prefer to avoid medical treatment if possible?
- Will you be starting menopause soon? If you are approaching menopause, you can expect uterine bleeding to naturally stop without treatment.
The answers to these questions will help you and your doctor select the treatment plan that is best for you.