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Menorrhagia / Heavy Menstrual Bleeding / Heavy Periods - Treatment

Medically Reviewed by Dr. Sunil Shroff, MBBS, MS, FRCS (UK), D. Urol (Lond) on Jun 21, 2018


Treatment

Menorrhagia is treated with medicines such as NSAIDs, tranexamic acid or hormones. Some cases are treated surgically.


Menorrhagia is first treated with medicines. If medicines do not work, then the patient may opt for surgery. The patient should be treated with iron tablets for anemia along with the specific treatment. Associated conditions such as infection and thyroid disease should also be treated.

Drugs used for the treatment of menorrhagia are:

Nonsteroidal antiinflammatory drugs (NSAIDs)

These include drugs such as mefenemic acid, ibuprofen, diclofenac and naproxen. They reduce pain and amount of bleeding. They are administered only during the menstrual period. Their most common side effect is gastritis.

Tranexamic acid

Tranexamic acid prevents breakdown of clots and reduces the amount of bleeding. It is used for women who would prefer to use a nonhormonal drug. Adverse effects include headache, nausea and diarrhea.


Oral Contraceptive Pills/ Birth Control Pills

Oral contraceptive pills help to regularize bleeding and at the same time provide contraception. Combined oral pills (that contain estrogen as well as progesterone) are used for patients with menorrhagia who desire contraception. Pills containing only progesterone are also useful in menorrhagia when used from the 5th to the 26th day of the cycle.

Danazol

Danazol is a hormonal drug that helps to reduce menstrual bleeding in menorrhagia.

Levonorgestrel releasing IUCD

Some intrauterine contraceptive devices release progesterone (in the form of levonorgestrel). Thus it helps as a contraceptive and at the same time reduces bleeding.

Surgical treatment

Surgery is carried out in women who have completed their family. Two types of procedures are available - endometrial ablation and hysterectomy. Endometrial ablation is used in those patients who do not want a complete removal of the uterus and do not have cancer of the uterus. However, repeat procedures may be needed in some cases. Hysterectomy is a procedure in which the uterus is removed completely.

References

  1. Apgar BS, Kaufman AH, George � Nwogu U, Kittendorf A. Treatment of Menorrhagia. American Family Physician 2007; 75 (12): 1813-19.
  2. Joanne Protheroe. Modern management of menorrhagia. Journal of Family Planning and Reproductive Health Care 2004; 30(2): 118�122
  3. Ely JW, Kennedy CM, Clark EC, Bowdler NC. Abnormal Uterine Bleeding: A Management Algorithm. JABFM 2006;19 (6): 590 - 602

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