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Hormonal therapies to reduce or stop menstrual bleeding have long been used to manage a number of gynecologic conditions including menstrual cramps (dysmenorrhea), heavy menstrual bleeding, irregular or other abnormal uterine bleeding, menstrual-related mood changes (premenstrual syndrome or premenstrual dysphoric disorder), and pelvic pain due to endometriosis or uterine fibroids.
Changes in menstrual bleeding may occur, such as a lighter flow or complete stop to the regular monthly menses, or abnormal bleeding throughout the cycle. Others have reported small weight gain, and increase in headaches or mood swings, and a decrease in libido .
Irregular menstrual pattern: irregular bleeding and spotting is common in the first three to six months of use. After that time periods become shorter and lighter, and 20% of women stop having periods after one year of use. [50]
DMPA can affect menstrual bleeding. After a year of use, 55% of women experience amenorrhea (missed periods); after two years, the rate rises to 68%. In the first months of use "irregular or unpredictable bleeding or spotting, or, rarely, heavy or continuous bleeding" was reported. [73]
Although copper IUDs may increase menstrual bleeding and result in painful cramps, [12] hormonal IUDs may reduce menstrual bleeding or stop menstruation altogether. [13] However, women can have daily spotting for several months after insertion, and it can take up to three months for there to be a 90% decrease in bleeding with hormonal IUDs. [14]
Tranexamic acid is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation. [6] [7] It is also used for hereditary angioedema. [6] [2] It is taken either by mouth, injection into a vein, [6] or by intramuscular injection.
Oral contraceptives are prescribed in the treatment of menorrhagia to help regulate menstrual cycles and prevent prolonged menstrual bleeding. The hormonal IUD ( Mirena ) releases levonorgestrel which thins the uterine lining, preventing excessive bleeding and loss of iron.
Irregular bleeding and spotting: Many women will experience some type of irregular, unpredictable, prolonged, frequent, or infrequent bleeding. [31] Some women also experience amenorrhea . For some women, prolonged bleeding will decline after the first three months of use.
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