Prevention

Usually dysfunctional uterine bleeding (DUB) results from unpredictable hormonal changes, so it cannot be prevented. But being overweight can affect your hormone production, which increases your risk for irregular menstrual bleeding. If you are overweight, losing weight may help prevent dysfunctional uterine bleeding.

Home Treatment

You can use home treatment for some problems related to dysfunctional uterine bleeding (DUB).

For menstrual pain and heavy bleeding, you can use a nonsteroidal anti-inflammatory drug (NSAID), such as over-the-counter ibuprofen. This type of medicine lowers prostaglandins, which cause menstrual pain, and reduces bleeding during your period. An NSAID works best when you start taking it 1 to 2 days before you expect pain to start. If you don't know when your period will start next, take your first dose of an NSAID as soon as bleeding or premenstrual pain starts. Take regular doses of the NSAID, as directed.

Irregular menstrual bleeding can lead to low levels of iron in the blood. This condition is known as anemia. You can prevent anemia by increasing the amount of iron in your diet.

Medications

Treating dysfunctional uterine bleeding (DUB) with medicines has fewer risks but doesn't always work as well 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), you may want to try medicines first.

Goals of medicine treatment

The goal of medicine treatment for dysfunctional uterine bleeding is to reduce or eliminate blood loss. This can be done 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:

• Birth control pills (synthetic estrogen and progesterone). Daily birth control pills prevent pregnancy. They also reduce the amount of heavy menstrual bleeding by about half.² In other words, when you take birth control pills, your menstrual bleeding can be half as heavy as it was before you took the pills. But when you stop taking the pills, irregular bleeding or perimenopausal symptoms may return.
• Progestins pills (synthetic progesterone). In some women, progestins can control endometrial growth and bleeding. You usually take progestins 10 to 12 days every month.
• The levonorgestrel intrauterine device (IUD). A doctor inserts this birth control device into your uterus through your vagina. It stays in your body for up to 5 years and releases levonorgestrel, a form of progesterone, into the uterus.
• Estrogen. In some severe or urgent cases, estrogen may be used to reduce bleeding.
• Hormone suppressors such as gonadotropin-releasing hormone analogues (GnRH-As). GnRH-As are rarely used. 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 medicine. Side effects with GnRH-As are common.

A medicine called tranexamic acid (such as Lysteda) is sometimes used for women who have bleeding that is heavier than normal. This medicine is not a hormone. It prevents bleeding by helping blood to clot. Talk to your doctor to find out if this option is right for you.

What to think about

Intravenous estrogen therapy is typically used when severe blood loss must be quickly stopped.