Start with the Basics

There are several options you may want to try to reduce your heavy menstrual bleeding. These include:

  • Ice packs – apply an ice pack to your abdomen for 20 minutes at a time, several times a day when bleeding is especially heavy.
  • Vitamins – Vitamin C supplements may help your body absorb iron and possibly strengthen blood vessels.
  • Iron – some research suggests iron supplements can reduce menstrual bleeding.

Medical Options

Most health care providers will recommend a medical therapy before moving on to other, more invasive, surgical recommendations.

The following options are medical therapies your health care provider may discuss with you, if you have heavy menstrual bleeding and need relief, depending on your personal health history.

  • Nonsteroidal anti-inflammatories (NSAIDs) – These drugs work by reducing levels of prostaglandins, hormone-like chemicals that interfere with blood clotting. They can reduce blood flow. Take these regularly during your period for best control- and always take with food.
  • Oral contraceptives –Oral contraceptives can reduce menstrual bleeding by preventing ovulation and thinning the endometrium. Some women will choose long cycle or continuous methods to reduce bleeding even further. For use only in women who do not have risk factors that make hormonal birth control use inadvisable.
  • Progestin –Progestin tablets work by reducing the effects of estrogen in your body, slowing growth of the uterine lining and reducing bleeding. But side effects may include irregular bleeding, weight gain, headaches, swelling and depression, leading many women to look for another option.
  • Gonadotropin-releasing hormone agonists (GnRH agonists) – These drugs are very effective in reducing menstrual blood flow by temporarily sending a woman into menopause. Short term side effects include menopausal symptoms, Long-term use could lead to osteoporosis because these drugs interfere with the activity of estrogen in the body.
  • Danazol –Danazol is a very weak form of the male hormone testosterone that blocks the action of estrogen in the body. Your period will stop in about four to six weeks, but side effects may include acne and reduced breast size.
  • Intrauterine device (IUD) – The levonorgestrel intrauterine system (Mirena) is approved to treat heavy menstrual bleeding in women who use intrauterine contraception as their method of birth control. The Mirena system slowly releases a low dose of the progestin hormone levonorgestrel and may be kept in place for up to five years. The main side effect can be some light bleeding between periods, particularly in the first three months of use. 

Surgical Options

  • Hysterectomy – Even though the majority of women with heavy menstrual bleeding do not need a hysterectomy, it is an effective treatment option and many women opt for the procedure. It is worth noting that hysterectomy is a major surgical procedure that requires hospitalization, several weeks of recovery, and permanently removes a woman’s ability to have children. Hysterectomy is also associated with a number of complications, with infection being the most common. Your health care provider should fully explain the surgery to you along with potential benefits and risks. Though some women may prefer hysterectomy to other surgical options, be sure you understand all your options before making a choice. Other, less invasive surgical options are included below.
  • Endometrial ablation – In this minimally invasive procedure, the lining of the uterus is destroyed via freezing, electricity, microwaves, radiofrequency (radio waves) or hot water. The procedure is performed with a mild anaesthetic in a doctor’s office or on an outpatient basis, and has a very quick recovery. Ablation also enables a woman to keep her uterus and, in many instances, may stop her periods altogether. If you choose this treatment option, you should be sure to continue using contraception, as necessary; pregnancy following ablation is not recommended.

Other surgical procedures, including myomectomy and uterine artery embolization, are recommended if fibroids are the cause behind the bleeding.