Medical Treatment of Menorrhagia

Treatment of menorrhagia (including medical management and drugs to be used for treatment) depends on various factors. These factors include,

  • Overall general health of the patient
  • Medical history of the patient
  • The cause of menorrhagia and severity of the problem (how severe is the bleeding)
  • Patient’s future child bearing plan
  • What the patient can tolerate (drugs, procedures or therapies)
  • What effect menorrhagia is causing to the patient’s lifestyle
  • And the opinion of the patient and partner and family members

Drug or medical therapy of menorrhagia include, use of the following, most commonly combination of two or more of these,

  • NSAIDs: use of non-steroidal anti-inflammatory drugs is common in menorrhagia. Pain or cramps during menstruation is common problem in menorrhagia patients and to reduce severity of pain, NSAIDs are commonly used, e.g. naproxen, ibuprofen etc. These drugs also reduce blood loss.
  • Tranexamic acid: this is useful in reducing blood loss. This drug need to be taken only during menstruation to reduce menstrual blood loss.
  • Oral contraceptive pills: oral contraceptives have additional benefit of controlling menstrual bleeding, in addition to the main role of contraception. Oral contraceptives regulate menstrual cycles and can reduce excessive and prolonged menstrual bleeding.
  • Oral progesterone: this can help correct/prevent hormonal imbalance during in women with menorrhagia and reduce severity of menstrual bleeding. This need to be taken for 10 days or more in each menstrual cycle to get best result.
  • Hormonal IUD: intrauterine device containing hormone (a progestin known as levonorgesterol) is useful in menorrhagia. This hormone is released slowly over several years. Regular release of the hormone makes the uterine lining thin and reduce menstrual blood flow as well as cramps associated with menstrual cycles.
  • Iron supplementation: due to excess blood loss every month during menstrual periods, anemia is common among patients of menorrhagia. Hence, your doctor may prescribe iron supplements. If you have low hemoglobin but not yet anemic, then also you can start iron supplementation to prevent anemia. Iron supplements should be taken for few months after hemoglobin level becomes normal, to replenish iron stores.
  • Menorrhagia may be due to thyroid problem. Treatment of thyroid problem usually restore normal menstrual bleeding in such patients.


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