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A normal menstrual cycle is 21–35 days in duration, with bleeding lasting an average of 5 days and total blood flow between 25 and 80 mL. Heavy menstrual bleeding is defined as total menstrual flow >80ml per cycle, soaking a pad/tampon at least every 2 hours, changing a pad/tampon in the middle of the night, or bleeding lasting for >7 days.
Combined oral contraceptives (COCs) can be used to treat menstrual cycle disorders including heavy menstrual bleeding, [9] and pelvic pain disorders such as endometriosis [10] and dysmenorrhea. [11] CHCs are also a first line treatment for polycystic ovary syndrome for menstrual abnormalities, acne, and hirsutism. [12]
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.
Dienogest 1 mg oral tablets (Dinagest) and 2 mg oral tablets (Valette) (not available in U.S.) – indicated for endometriosis; Dienogest 2 mg and estradiol valerate 3 mg oral tablets (Natazia) (U.S.) – indicated for contraception and menorrhagia [12] [31] 2 dark yellow tablets each containing 3 mg estradiol valerate
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]
According to a study published in the Journal of Global Health Reports in 2022, "Two-thirds of the 16.9 million low-income women in the U.S. could not afford menstrual products in the past year ...
If birth control is an option for you, try going on a hormonal birth control pill, which “shortens the length, amount, and flow of period bleeding,” leading to fewer cramps, Dr. Ross says.
Women who are experiencing menstrual dysfunction due to female athlete triad are sometimes prescribed oral contraceptives as pills that can create menstrual bleeding cycles. [78] However, the condition's underlying cause is energy deficiency and should be treated by correcting the imbalance between calories eaten and calories burned by exercise.