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What are the common treatments for menstrual irregularities?

Treatments for menstrual irregularities often vary based on the type of irregularity and certain lifestyle factors, such as whether a woman is planning to get pregnant.

Treatment for menstrual irregularities that are due to anovulatory bleeding (absent periods, infrequent periods, and irregular periods) include:1,2

  • Oral contraceptives
  • Cyclic progestin
  • Treatments for an underlying disorder that is causing the menstrual problem, such as counseling and nutritional therapy for an eating disorder

Treatment for menstrual irregularities that are due to ovulatory bleeding (heavy or prolonged menstrual bleeding) include:1,3,4,5,6

  • Insertion of a hormone-releasing intrauterine device
  • Use of various medications (such as those containing progestin or tranexamic acid) or nonsteroidal anti-inflammatory medications

If the cause is structural or if medical management is ineffective, then the following may be considered:

  • Surgical removal of polyps or uterine fibroids
  • Uterine artery embolization, a procedure to block blood flow to the uterus
  • Endometrial ablation, a procedure to cauterize (remove or close off by burning) blood vessels in the endometrial lining of the uterus
  • Hysterectomy

Treatment for dysmenorrhea (painful periods) include:7

  • Applying a heating pad to the abdomen
  • Taking nonsteroidal anti-inflammatory medications
  • Taking contraceptives, including injectable hormone therapy or birth control pills, using varied or less common treatment regimens

Citations

  1. ACOG Committee on Practice Bulletins—Gynecology, American College of Obstetricians and Gynecologists. (2013). Practice bulletin no. 136: Management of abnormal uterine bleeding associated with ovulatory dysfunction. Obstetrics and Gynecology, 122(1), 176–185. PMID: 23787936. Retrieved December 2, 2016, from https://www.guideline.gov/summaries/summary/47451
  2. Practice Committee of the American Society for Reproductive Medicine. (2008). Current evaluation of amenorrhea. Fertility and Sterility, 90, S219–S225.
  3. Apgar, B. S., Kaufman, A. H., George-Nwogu, U., & Kittendorf, A. (2007). Treatment of menorrhagia. American Family Physician, 75, 1813–1819.
  4. Lethaby, A., Irvine, G., & Cameron, I. (1998). Cyclical progestogens for heavy menstrual bleeding. Cochrane Database of Systematic Reviews, 4, CD001016.
  5. Lethaby, A. E., Cooke, I., & Rees, M. (2005). Progesterone/progestogen releasing intrauterine systems versus either placebo or any other medication for heavy menstrual bleeding. Cochrane Database of Systematic Reviews, 4, CD002126.
  6. Lethaby, A., Shepperd, S., Cooke, I., & Farquhar, C. (1999). Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database of Systematic Reviews, 2, CD000329.
  7. Proctor, M. L., & Farquhar, C. M. (2007). Dysmenorrhoea. Clinical Evidence, pii, 0813.
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