Dysfunctional Uterine Bleeding

Treating dysfunctional uterine bleeding (DUB) with medicines has fewer risks but doesn't always work as well 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 (Reference menopause Opens New Window), you may want to try medicines first.

Goals of medicine treatment

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

• Reducing the Reference endometrium's Opens New Window 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:

• Reference Birth control pills (synthetic Reference estrogen Opens New Window and progesterone). Daily birth control pills prevent pregnancy. They also reduce the amount of heavy menstrual bleeding by about half.^{Reference 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.
• Reference Progestin pills (synthetic Reference progesterone Opens New Window). In some women, progestins can control endometrial growth and bleeding. You usually take progestins 10 to 12 days every month.
• The Reference 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.
• Reference Estrogen. In some severe or urgent cases, estrogen may be used to reduce bleeding.
• Hormone suppressors such as Reference gonadotropin-releasing hormone analogues (GnRH-As). GnRH-As are rarely used. 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.

A medicine called tranexamic acid (such as Lysteda) is sometimes used for women who have bleeding that is heavier than normal. This medicine is not a hormone. It prevents bleeding by helping blood to clot. Talk to your doctor to find out if this option is right for you.

What to think about

Intravenous estrogen therapy is typically used when severe blood loss must be quickly stopped.

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