Abnormal Uterine Bleeding Treatment Options

Treatment recommendations for abnormal uterine bleeding (AUB) depend on the diagnosis. Both medication and surgery are used to treat AUB. Typically, less invasive therapies should be considered first. Treatment choices depend on your age, your desire to preserve fertility and the cause of the bleeding (dysfunctional or structural). Other treatments may reduce your menstrual bleeding to a light to normal flow.

Medication for bleeding caused by hormonal imbalances include low-dose birth control pills (oral contraceptives), progestins and nonsteroidal anti-inflammatory drugs (NSAIDs).

Oral contraceptives (OCs) and contraceptive patches (CPs) are almost 100 percent effective in restoring cyclic menstrual periods. Pills containing less estrogen tend to work better to reduce bleeding. OCs or CPs can reduce menstrual flow, improve and control menstrual patterns and relieve pelvic pain during menstruation. They can be considered for PMS treatment if symptoms are mostly physical, but they may not be effective if mood symptoms are the primary symptom. However one newer brand of OCs containing a form of progesterone called drospirenone has been shown in clinical studies to reduce some mood-related symptoms such as anxiety, irritability, tearfulness, and tension among others.

Birth control pills may not be an appropriate treatment choice if you smoke, have a history of pulmonary embolism (blood clots in your lungs) or are highly sensitive to side effects of this medication.

Progestins used to manage dysfunctional bleeding include oral Provera, norethindrone and Depo-Provera, an injectable form of the progestin, Provera, which is an oral preparation. Progestins may reduce menstrual bleeding by up to 20 percent. The Mirena or the Progestasert IUDs may help to decrease heavy bleeding for some women by slowly releasing progestin into the uterus for up to five years. It may help to reduce menstrual flow by up to 40 percent. This device, however, may increase the risk for ectopic pregnancy, and hormonal side effects, such as bloating.