The treatment for heavy periods, as for any other medical condition, depends upon the cause and this is often difficult or impossible to determine. Drugs will usually be tried first in an attempt to reduce the blood loss, along with iron tablets if the patient is anaemic. The doctor may then decide to try to help by providing drug treatment which involves taking one or other of two types of tablets – non-hormonal or hormonal drugs.
Non-hormonal drugs
Anti-prostaglandins (i.e Ponstan). These are taken just before and during the course of the period itself and act on the womb to reduce the flow of blood from its lining. They also provide effective pain relief if the periods are painful as well as heavy. These drugs can provide up to about a 25 per cent reduction in blood loss in about 75 per cent of women and are a useful first line of treatment.
Drugs which act by strengthening the small blood vessels in thewomb lining (i.e.Tranexamic acid). These drugs are needed to be given only during the few days of woman’s periods and can considerably reduce the amount of blood loss.
Hormonal drugs
Oral contraceptive pill: can be very effective and may be appropriate if contraception is also required.
Progestogens (i.e, Provera, Duphaston): which can be taken for 1-3 weeks each month, and which can both reduce the blood loss to a certain extent and also regulate the periods if they are erratic.
Stronger hormones (LHRH analogues, danazol).
These are extremely effective drugs, but they may cause troublesome side-effects and should be avoided for long-term treatment.
Progesterone releasing device (MIRENA)
If drug therapy has not helped, and any other general disorders have been excluded, the progesterone releasing device (MIRENA) is the next reliable solution. This is a special coil which releases small amount of progesterone into the lining of the womb and unlike the standard coils, reduces the menstrual blood loss in 90% of women after one year.
Surgical Procedures
If all the medical treatment and the progesterone releasing device fail and woman no longer wish to have children an operation may be necessary. Possible operations are endometrial ablation, transcervical endometrial resection (TCRE) and hysterectomy.