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Is drug therapy an option for me?

Drug therapy can be an option if you still plan to have children in the future. There are two types of drugs that may be taken to reduce bleeding; non-hormonal and hormonal. Neither will affect your ability to have children once you stop taking them.

Non-Hormonal Drugs

Non-hormonal drugs are only for short-term use. They reduce bleeding in about 40% of women who take them.

NSAIDS (non-steroidal anti-inflammatory drugs e.g. ibuprofen)

NSAIDs can reduce bleeding 25% to 35%. Long-term use, however, can increase your risk of gastrointestinal bleeding (bleeding in your digestive track), ulcers, and anemia.

Over-the-counter NSAIDs should be taken about every eight hours while you are having your period. Prescription NSAIDS should be taken as prescribed by your doctor. Your heavy periods will return when you stop taking the NSAIDs.

Aminocaproic (available in the US) or Tranexamic acid (available outside US)

Aminocaproic and Tranexamic acid aid in blood clotting (blood thickening). These acids can reduce blood flow by up to 50%. Because they aid in blood clotting, they may also cause blood clots that can be dangerous. This needs to be closely watched by your doctor. Other possible side effects can include blurred vision, dizziness, diarrhea, vomiting, rapid weight gain, and fatigue.

Mefenamic acid

Mefenamic acid relieves swelling in the uterus. It can reduce blood flow by 30%. Side effects include headaches, nausea, gaseousness, diarrhea or constipation, depression, fatigue, and dry mouth.

Hormonal Drugs

Hormonal drugs, which contain estrogen and/or progestin, may lighten your period. However, they must be used continuously and only manage the problem -- they do not resolve it. 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 should become lighter (on average by 45%) and more controlled, as long as you stay on the hormones. They must be taken for 3-4 cycles to see results. However, 50-59% of women on birth control pills find they do not reduce their heavy bleeding to the extent they would like.

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 help prevent pregnancies and decrease your chance of some types of cancer. While taking birth control pills, you may have headaches, breast tenderness and enlargement, and dizziness. Long-term use can increase your risk of blood clots.

Progestogens (progestins and natural progesterone)

Progestins are made to 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. They can be taken in the form of a pill or via an IUD (intrauterine device). Both thin the lining of the uterus, reducing blood flow. Oral progestins on average reduce bleeding by 20-30%. Some IUDs can reduce blood flow up to 90%. Side effects may include bloating, depression, moodiness, and breakthrough bleeding. 27% of women with IUDs do not see an improvement in their heavy periods. Only 50% of women on oral progestins claim to have a more controlled period.

Side effects may include bloating, depression, moodiness, weight gain, and breakthrough bleeding. Natural progesterone has recently been developed and may have fewer side effects but this has not been proven.