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Heavy Periods

Menstrual Regulation – controlling period like bleeding

Heavy periods and extra bleeding outside of your normal scheduled period can be handled in a number of ways depending on what tests show. Once we have done an appropriate evaluation, and we are sure there is nothing “wrong,” you may not choose to do anything. You can change your mind at any time, and we can move down the list on this page of options. If the bleeding is heavy then you may become anemic. A low blood count is a reason to do something. If you elect to do nothing then you will need Yearly evaluation and the bleeding should stop when you go into menopause. The average age of menopause is 51 years old.

Step 1

Medications Typically Used for Contraception

These can be effective in controlling extra bleeding and/or heavy periods. These options include:

  • Estrogen and Progesterone: Birth control pills, the patch and the vaginal ring offer the best chance of period management with the fewest side effects. Any method, and any pill should work. Women older than 35 who smoke should not take birth control pills. There are other reasons why women will not or should not take birth control pills so you should consult your physician before starting birth control.
  • Depo Provera: This is a shot which can make periods disappear. You get the shot once every three months. It may take up to 9 months before there is no menstrual bleeding. In the mean while, many women have daily spotting (no need for a pad). It is safe for women to have no periods while on DepoProvera.
  • IUD with Progesterone (Mirena): This is a form of contraception which can help regulate bleeding. Progesterone is the medicine in this IUD, the medicine in the Depo Provera shot and it is ½ of the medicine in the birth control pill. Progesterone makes the cells which line the uterus stop growing. The less they grow, the lighter the periods. Mirena may not work as well or as quickly as Depo Provera, but it has almost no side effects.  [read more at: http://www.mirena-us.com/]

Medicine Which is NOT Contraceptive

  • Progesterone Pills: These progesterone pills are not contraceptive. Taken daily, progesterone makes the cells which line the inside of the uterus stop growing. Provera is very effective in stopping a heavy period here and now. Some women do not like the way it makes them feel, which limits its use. There is usually no problem with MPA (medroxyprogesterone) in patients who smoke or have high blood pressure or headaches…[read more]

Step 2

Surgery and More

These procedures may provide temporary or permanent solutions to your bleeding.

  • Leuprolide Acetate: This is a medicine given by injection. It is a Temporary hormonal solution to the bleeding. Leuprolide is like DepProvera, but stronger. Leuprolide causes a temporary menopause, which makes your estrogen level drop really low. Since estrogen causes most of the bleeding, a lack of estrogen fixes most bleeding. This medicine is Not a long term solution. Leuprolide is used to stop the bleeding in preparation for surgery or to stop the bleeding while we figure out what to do next. Leuprolide does not work for women already in menopause…[read more]
  • Endometrial Resection with Ablation: This is a surgery which removes the cells that line the uterus. It is like a deeper D&C. This is an outpatient procedure and you will go home from the hospital the same day. This surgery cures approximately 70% of women of heavy bleeding. If this does not work then you may need to consider a hysterectomy…[read more]
  • Uterine Artery/Fibroid Embolization: This is not surgery, but rather it is like “reverse angioplasty” of the blood vessels of the uterus. The goal is to CLOG the blood vessels going to the uterus. Without a blood supply the uterus can not do any bleeding of its own. It works in about 80-90% of women. It is typically done for  large fibroids.
  • Hysterectomy: This is a surgery to remove the uterus, but does not remove the ovaries, thus you will no longer be able to get pregnant. Hysterectomy is a 100% cure for the bleeding.



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