Treating (DUB) with medicines has fewer risks but is not always as effective 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 (), you may want to try medicines first.
Goals of medical treatment
The goal of medicine treatment for dysfunctional uterine bleeding is to reduce or eliminate blood loss. This can be accomplished in one or both of the following ways:
- Reducing the rate of bloodloss
- Regulating or eliminating the menstrual cycle by changinghormonal levels
There are several hormone therapies for managing dysfunctional uterine bleeding. These treatments help reduce bleeding and regulate the menstrual cycle:
- Progestins (synthetic). In some women, progestins can controlendometrial growth and bleeding. You usually take progestins 10 to 12 daysevery month.
- Birth control pills (synthetic and progesterone). Daily birth control pillsprevent pregnancy. They also reduce the amount of heavy menstrual bleeding byabout half.2 In other words, when you take birthcontrol pills, your menstrual bleeding can be half as heavy as it was beforeyou took the pills. But when you stop taking the pills, irregular bleeding orperimenopausal symptoms may return.
- Thelevonorgestrel intrauterine device (IUD). A doctorinserts this birth control device into your uterus through your vagina. Itstays in your body for up to 5 years and releases levonorgestrel, a form ofprogesterone, into the uterus. For more information, seeintrauterine device (IUD) for birth control.
- Estrogen. Most dysfunctional uterine bleeding istreated with birth control pills or progestin. But in some severe or urgent cases, estrogen maybe used to reduce bleeding.1
- Hormone suppressors such asgonadotropin-releasing hormone analogues (GnRH-As).GnRH-As are rarely used now. These drugs reduce estrogen production, makingyour body think it is in menopause. This reduces or stops menstrual periods foras long as you take the medicine. Side effects with GnRH-As are common.
Women who have bleeding that is heavier than normal may want to try a medicine called tranexamic acid (such as Lysteda). 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 generally used on an urgent basis, when severe blood loss must be quickly stopped. After bleeding subsides, a week or so of progestin or estrogen-progestin therapy is added to help return the menstrual cycle to normal.