If you have abnormal uterine bleeding, let your doctor know and they will help you find ways to treat it. Your doctor will determine the best course of action based on your health, any pre-existing conditions, and desire for biological children. The treatments may be designed to return your menstrual cycle to normal, to stop periods altogether, or to reduce heavy menstrual bleeding.
Hormone therapy. Taking a daily birth control pill with estrogen and progestin may help control your menstrual cycle and reduce cramping or bleeding, while also preventing pregnancy.
Nonsteroidal anti-inflammatory drugs (NSAIDs). Taking regular doses of pain medications such as Ibuprofen can help relieve menstrual pain and heavy bleeding associated with menorrhagia.
Progestin IUD. Having a progestin IUD inserted can help control your menstrual cycle, prevent pregnancy, and ease menorrhagia symptoms.
Tranexamic acid. This medication helps slow the breakdown of blood clots, preventing excessive bleeding. It is usually recommended for menstruating teenagers, or to treat acute AUB when the bleeding is too severe.
Endometrial ablation. An endometrial ablation procedure is also used when other treatments do not work to treat uterine fibroids. This procedure uses a laser, heat, electricity, or freezing to destroy (ablate) the uterine lining. However, endometrial ablation is not recommended for those who wish to have children in the future.
Hysterectomy. This surgery involves removing the uterus and sometimes the fallopian tubes and/or ovaries. It is invasive and requires a hospital stay, and will mean you cannot get pregnant in the future. This procedure is recommended for endometrial cancer, adenomyosis, and severe uterine fibroids, often as a last resort for when hormone treatments fail to control menorrhagia. After a hysterectomy if your ovaries have also been removed, you will have to take estrogen or else you will start menopause right away.
Myomectomy. If you have uterine fibroids, they can be surgically removed through this procedure without affecting your ability to have children.
Uterine artery embolization. This procedure is used when other treatments do not work, mostly for uterine fibroids or polyps. During the procedure, the fibroids or polyp’s blood supply is cut off by putting tiny particles in the uterine arteries, causing the fibroids or polyps to shrink.
For people who are obese or who have polycystic ovary syndrome, lifestyle changes such as eating a different diet and following an exercise regime may help reduce abnormal bleeding symptoms.
In some cases, your doctor may recommend a wait-and-see approach to determine if your irregular vaginal bleeding can go away on its own or get better over time. This is usually recommended for teenagers or people nearing menopause, as they are going through hormone changes that will level out over time.