Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce menstrual bleeding by up to 30 percent, particularly when they are taken with oral contraceptives. These medications include ibuprofen, naproxen and mefenamic acid. Common side effects of NSAIDs include stomach upset and gas. Medication therapy is often successful and a good option if you want to preserve your fertility or avoid surgery. The benefits last only as long as the medication is taken, so if you choose this route, you should know that medical treatment is a long-term commitment.
These surgical options may be recommended if drug therapy fails:
- hysteroscopic treatment of anatomic abnormalities (such as polyps or fibroids)
- hysteroscopic endometrial ablation or endomyometrial resection (EMR)
- global or blind endometrial ablation
Except for hysterectomy, in each of these options the uterus is preserved and only the uterine lining is destroyed to reduce excessive bleeding. However, though these options preserve the uterus, fertility is destroyed with some of the procedures and childbearing after the procedure is not an option. There are other important considerations for each of these treatment options. Risks common to all surgical options include infection, hemorrhage and other complications, some of which are described below.
Dilation and curettage (D&C): once a mainstay in the treatment of excessive menstrual bleeding, newer options are now considered more effective. During a D&C, which is performed on an outpatient basis using general anesthesia, your uterine lining is scraped away. No viewing mechanism is used, so the procedure is done "blindly." Many health care professionals no longer recommend a D&C because it's simply not effective.