Heavy menstrual bleeding, termed menorrhagia, can be caused by a hormonal imbalance, uterine fibroids or polyps. The Mayo Clinic states that a woman with heavy menstrual bleeding loses 81 mL during her period; in comparison, a normal menstrual flow is 30 to 44 mL of blood. Medication is the usual treatment for heavy menstrual bleeding, though some women may require surgery.
Hormonal Birth Control
The Merck Manual Home Edition states that combination birth control, which has both estrogen and progestin, are the first choice for heavy menstrual bleeding. The hormones thin the uterine lining, reducing the amount of blood released during menstruation. The Mayo Clinic adds that oral progesterone, which is taken for at least 10 days a month, is another option. Another option is a hormonal intrauterine device (IUD), which releases progestin directly into the uterus.
Other Medications
The Mayo Clinic notes that other medication options for heavy menstrual bleeding are used if the woman has other related conditions. For example, if she also has anemia, a condition characterized by not enough healthy red blood cells, she can take iron supplements. If the woman also has painful cramps, called dysmenorrhea, she can take non-steroid anti-inflammatory drugs (NSAIDs), like ibuprofen.
Outpatient Surgeries
For women who do not respond to the medication, surgery may be performed. Some procedures, like dilation and curettage and endometrial ablation, are outpatient procedures, according to the Mayo Clinic. Dilation and curettage involve dilating the woman's cervix and scraping off some uterine lining tissue to reduce the blood flow during menstruation. Endometrial ablation results in the destruction of the endometrium, resulting in little or no menstrual flow. Endometrial ablation does reduce the woman's chance of getting pregnant in the future.
Hysterectomy
If no other treatment works, a hysterectomy may be performed, which is a procedure that requires hospitalization. The Mayo Clinic states that a hysterectomy involves surgically removing the woman's uterus and cervix. Not only does this procedure stop menstruation, it also causes the woman to become sterile.
