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Treatment
The course of treatment for excessive menstrual bleeding depends on several variables. Among them are :
- Your overall health and medical history.
- The reason behind the ailment and the extent of its severity.
- How successfully you handle specific medications or treatments.
- The possibility that your cycles will lighten up soon.
- Your plans to have children.
- How the condition affects your lifestyle.
- Your opinion or personal choices.
Drugs
The following medications may be prescribed to treat prolonged menstrual bleeding:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs that assist lessen menstrual blood loss include ibuprofen (Advil, Motrin IB, and other brands) and naproxen sodium (Aleve). Menstrual cramps may also be less uncomfortable if you take an NSAID.
- Tranexamic acid. Lysteda, tranexamic acid, helps lessen menstrual blood loss. You only need to take this medication when you start bleeding.
- Oral contraceptives. In addition to pregnancy control, oral contraceptives can help control irregular menstrual cycles and relieve heavy or protracted menstrual bleeding.
- Oral progesterone. Progesterone is a naturally occurring hormone that can help regulate hormones and lessen excessive menstrual flow. Progestin is the term for progesterone in synthetic form.
- Hormonal IUD (Mirena, Liletta, others). Levonorgestrel is the type of progestin released by this intrauterine device. It thins the lining of the uterus and lessens discomfort and monthly blood flow.
- Other medicines. GnRH medications are also known as gonadotropin-releasing hormone agonists and antagonists. They aid in reducing excessive uterine bleeding. Relugolix in combination with Myfembree, an estrogen and progestin, may help reduce bleeding from fibroids. Fibroid-related bleeding is treated with elagolix (Oriahnn), a combination of estrogen and progestin. By itself, elagolix (Orilissa) may be able to reduce endometriosis-related bleeding.
You might need to stop taking hormone medication altogether or switch to a different one if you experience severe monthly bleeding.
You might need to take iron supplements if your excessive menstrual flow is the cause of your anemia. Rather than waiting to become anemic, you might be started on iron supplements if your iron levels are low but you're not yet anemic.
Procedures
If medication is ineffective for your severe monthly bleeding, you might require surgery. Treatment options for this condition include:
Dilation and curettage (D&C). Your doctor will open your cervix throughout this operation. Dilating the cervix is another term for this. The uterine lining is then scraped or suctioned by the doctor. Curettage is another name for this. To identify the cause of the irregular uterine bleeding, you could need a D&C. Bleeding may be caused by uterine cancer, fibroids, or polyps. In the event of a miscarriage, a D&C might be necessary to empty the uterus entirely. Doctors frequently utilize hysteroscopy in conjunction with D&C to assist in locating the cause of uterine hemorrhage.
Uterine artery embolization. This surgery aims to stop the blood supply to uterine fibroids. Reduced blood supply to fibroids aids in their shrinkage. A catheter is inserted by the surgeon into the major artery in the thigh to perform the surgery. The femoral artery is another name for this. In order to stop the blood supply to the fibroid, the surgeon inserts tiny beads or sponges using a catheter that is guided to the uterine blood arteries.
Focused ultrasound. By using radiofrequency energy and ultrasound waves to target and eliminate fibroids, this technique reduces their size. No cuts are necessary.
Myomectomy. Uterine fibroids are surgically removed in this manner. Your surgeon may use multiple tiny abdominal incisions to accomplish the myomectomy, depending on the quantity, size, and location of the fibroids. This method is also referred to as laparoscopic. Alternately, the surgeon might insert a thin, flexible tube into the cervix and vagina to view and remove uterine fibroids or polyps. Another name for this is the hysteroscopic method.
Endometrial ablation. The uterine lining is destroyed during this surgery. Another name for the process of eliminating tissue is ablation. To destroy the tissue, the surgeon applies heat, radio waves, or a laser to the uterine lining.
After endometrial ablation, your menstrual flow may be significantly lighter. Although it is unlikely, pregnancy following endometrial ablation is possible and may pose a risk. It is advised to use trustworthy or long-term birth control till menopause.
Endometrial resection. The uterine lining is removed by use of an electrosurgical wire loop by the surgeon. It is not advised to become pregnant following this treatment.
Hysterectomy. The uterus and cervix are removed during this operation. It terminates both the menstrual cycle and the capacity to conceive. Under anesthesia, a hysterectomy may necessitate a brief hospital stay. Removing the ovaries may result in early menopause. Bilateral oophorectomy is the term used to describe the removal of both ovaries.
A large number of these surgeries are performed as outpatient treatments. Although you might require a general anesthetic, you should be able to return home the same day. You could require a short hospital stay following a hysterectomy or abdominal myomectomy.
Heavy menstrual bleeding may occasionally indicate the presence of another illness, such as thyroid dysfunction. When that happens, the disease is usually treated, and the periods go lighter.
1. Tranexamic acid Oral: 1.5 g twice daily or 1 g 3 times daily for 4 to 10 days.
Uterine artery embolization. This surgery aims to stop the blood supply to uterine fibroids. Reduced blood supply to fibroids aids in their shrinkage. A catheter is inserted by the surgeon into the major artery in the thigh to perform the surgery. The femoral artery is another name for this. In order to stop the blood supply to the fibroid, the surgeon inserts tiny beads or sponges using a catheter that is guided to the uterine blood arteries.
Focused ultrasound. By using radiofrequency energy and ultrasound waves to target and eliminate fibroids, this technique reduces their size. No cuts are necessary.
Myomectomy. Uterine fibroids are surgically removed in this manner. Your surgeon may use multiple tiny abdominal incisions to accomplish the myomectomy, depending on the quantity, size, and location of the fibroids. This method is also referred to as laparoscopic. Alternately, the surgeon might insert a thin, flexible tube into the cervix and vagina to view and remove uterine fibroids or polyps. Another name for this is the hysteroscopic method.
Endometrial ablation. The uterine lining is destroyed during this surgery. Another name for the process of eliminating tissue is ablation. To destroy the tissue, the surgeon applies heat, radio waves, or a laser to the uterine lining.
After endometrial ablation, your menstrual flow may be significantly lighter. Although it is unlikely, pregnancy following endometrial ablation is possible and may pose a risk. It is advised to use trustworthy or long-term birth control till menopause.
Endometrial resection. The uterine lining is removed by use of an electrosurgical wire loop by the surgeon. It is not advised to become pregnant following this treatment.
Hysterectomy. The uterus and cervix are removed during this operation. It terminates both the menstrual cycle and the capacity to conceive. Under anesthesia, a hysterectomy may necessitate a brief hospital stay. Removing the ovaries may result in early menopause. Bilateral oophorectomy is the term used to describe the removal of both ovaries.
A large number of these surgeries are performed as outpatient treatments. Although you might require a general anesthetic, you should be able to return home the same day. You could require a short hospital stay following a hysterectomy or abdominal myomectomy.
Heavy menstrual bleeding may occasionally indicate the presence of another illness, such as thyroid dysfunction. When that happens, the disease is usually treated, and the periods go lighter.
Prescription
Use these drugs to treat prolonged menstrual bleeding. It can either be one or a combination of the following.
1. Tranexamic acid Oral: 1.5 g twice daily or 1 g 3 times daily for 4 to 10 days.
2. Ibuprofen tablets: Take 800 mg 3 times a day for 3 to 5 days.
3. Norethsterone oral: Take 5 mg 3 times a day for 10 days.
Or 10 mg once a day for 10 days
it can take upto 3 months or more.
NB: Patients are encouraged to consult a clinician before starting treatment.
References:
1. Mayo Clinic
2. Medscape
3. WebMD
4. Drugs.com
Related: Treatment for gonorrhea in children
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