Treating dysfunctional uterine bleeding with medications has fewer risks but is not always as effective 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 (menopause), medications may be right for you.²

Goals of medical treatment

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

• Reducing the endometrium's 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:

• Progestins (synthetic progesterone). In some women, progestins can control endometrial growth and bleeding.² You usually take progestins 10 to 12 days every month.
• Birth control pills (synthetic estrogen and progesterone). Daily birth control pills prevent pregnancy. For more information, see combination hormonal methods.
• The levonorgestrel intrauterine device (IUD). A health professional inserts this birth control device into your uterus through your vagina. It releases levonorgestrel, a form of progesterone, into the uterus. For more information, see intrauterine device (IUD) for birth control.
• Estrogen. Most dysfunctional uterine bleeding is treated with birth control pills or progestin. But in other cases, estrogen may reduce bleeding.³
• Hormone suppressors such as gonadotropin-releasing hormone analogues (GnRH-As). GnRH-As are rarely used now. 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 medication. Side effects with GnRH-As are common.

What To Think About

Intravenous estrogen therapy is generally used on an urgent basis, when severe blood loss must be quickly stopped. After bleeding subsides, a week or so of progestin or estrogen-progestin therapy is added to help return the menstrual cycle to normal.