If you think you may want children in the future, drug therapy could be an option to treat your heavy bleeding.
Non-hormonal drugs are for short-term use only. They reduce bleeding in some women who take them; however, they must be used continuously and only manage the problem—they don’t resolve it. When you stop taking them, your heavy periods are likely to return.
NSAIDs (non-steroidal anti-inflammatory drugs, like ibuprofen)
NSAIDs may reduce bleeding by 45%1 but long-term use can increase your risk of gastrointestinal bleeding (bleeding in your digestive tract), ulcers and anemia.
Over-the-counter NSAIDs should be taken about every eight hours while you have your period. Take prescription NSAIDs as prescribed by your doctor. Your heavy periods will return when you stop taking the NSAIDs. Long-term NSAIDs use has been linked to renal damage.
Tranexamic acid (Lysteda®)
This medication, which helps to prevent blood clots from breaking down, is taken for five days during your period. It has been shown to help reduce blood flow by up to 40-65%.2
Because it aid in blood clotting, it may also cause blood clots that can be dangerous. Your doctor will want to monitor you closely. Other possible side effects include headache, sinus and nasal symptoms; back, abdominal, musculoskeletal, or joint pain; muscle cramps; migraine; anemia; and fatigue.
Hormone-based drugs / devices
Although hormonal medications (which contain estrogen and/or progestin) may lighten your period, they only manage the problem—like non-hormonal drugs, they don’t resolve it. They must be used continuously. When you stop taking them, your heavy periods are likely to return.
Birth control pills
Birth control pills stabilize the body’s estrogen and progestin levels. As a result, bleeding may become lighter and more controlled, as long as you stay on the hormones. However, some women on birth control pills find that this form of hormone therapy does not reduce their heavy periods to the extent they would like. They must be taken for three to four cycles to see results.
There are many brands of birth control pills that contain different hormone levels. Ask your doctor which would be best for you.
Birth control pills also prevent pregnancy and may decrease your risk for some types of cancer. While taking birth control pills, you may have nausea, headaches, and/or weight gain. Long-term use can increase your risk for blood clots.
Progesterone hormone therapy (progestins and natural progesterone)
Progestins act as a replacement for progesterone, a hormone that a woman’s body naturally produces. This is an option for women who are producing too much estrogen and not enough progesterone. Polycystic ovary syndrome and anovulation are common conditions associated with this imbalance.
Progestin is available in several forms: oral progestin pills, an implant under your skin (Implanon®), or as an IUD (intrauterine device). They thin the lining of the uterus, which can help to reduce blood flow. Side effects can include intermenstrual bleeding/spotting, depression, acne, headaches, nausea, weight gain and hair loss. Natural progesterone has recently been developed and may have fewer side effects, but this has not been proven.