Dysfunctional Uterine Bleeding - Medications

Medications

Treating dysfunctional uterine bleeding (DUB) with medicines has fewer risks but is not always as effective as surgical treatment. If you plan to become pregnant in the future, or if you are nearing the time when your menstrual periods will stop (menopause), you may want to try medicines first.

Goals of medical treatment

The goal of medication treatment for dysfunctional uterine bleeding is to reduce or eliminate blood loss. This can be accomplished in one or both of the following ways:

• Reducing the endometrium's rate of blood loss
• Regulating or eliminating the menstrual cycle by changing hormonal levels

Medication Choices

There are several hormone therapies for managing dysfunctional uterine bleeding. These treatments help reduce bleeding and regulate the menstrual cycle:

• Progestins (synthetic progesterone). In some women, progestins can control endometrial growth and bleeding. You usually take progestins 10 to 12 days every month.
• Birth control pills (synthetic estrogen and progesterone). Daily birth control pills prevent pregnancy. They also reduce the amount of heavy menstrual bleeding by about half.² In other words, when you take birth control pills, your menstrual bleeding can be half as heavy as it was before you took the pills. But when you stop taking the pills, irregular bleeding or perimenopausal symptoms may return.
• The levonorgestrel intrauterine device (IUD). A doctor inserts this birth control device into your uterus through your vagina. It stays in your body for up to 5 years and releases levonorgestrel, a form of progesterone, into the uterus. For more information, see intrauterine device (IUD) for birth control.
• Estrogen. Most dysfunctional uterine bleeding is treated with birth control pills or progestin. But in other cases, estrogen may be used to reduce bleeding.¹
• Hormone suppressors such as gonadotropin-releasing hormone analogues (GnRH-As). GnRH-As are rarely used now. These drugs reduce estrogen production, making your body think it is in menopause. This reduces or stops menstrual periods for as long as you take the medicine. Side effects with GnRH-As are common.

What To Think About

Intravenous estrogen therapy is generally used on an urgent basis, when severe blood loss must be quickly stopped. After bleeding subsides, a week or so of progestin or estrogen-progestin therapy is added to help return the menstrual cycle to normal.