If your period is negatively impacting your life, your doctor can help determine the cause.
Let's look at some of the possible treatments.
Having abnormal uterine bleeding can be a difficult and isolating experience, but having the right information can give you ways to manage it. There are a variety of medical and non-medical treatments to manage abnormal uterine bleeding and its symptoms.
Medical treatments
There are multiple hormonal options for treating abnormal uterine bleeding. Many of these are in the form of a pill and are taken orally. This includes oral hormonal treatments such as progestogen (provera) or the combined pill, more commonly referred to as ‘the pill’ (oestrogen and progestogen), both of these options are also used as oral contraceptives. You may also be offered hormonal treatments in the form of an injection called Depo-Provera.
Hormonal options
Non-hormonal treatment options consist of anti-inflammatory medications or medications that work to decrease bleeding. Tranexamic acid is taken in tablet form and is used to stop heavy bleeding caused by your period. It works by slowing down the time it takes your body to break down a blood clot. When you bleed your body forms blood clots to stop the bleeding, in some people these clots break down or dissolve causing excessive bleeding.
Non-hormonal options
Intrauterine devices, also known as the IUD, can be used to treat heavy periods and abnormal uterine bleeding. There are two forms of IUD, the Mirena and the Copper IUD. Only the Mirena is used to treat abnormal uterine bleeding. It works by releasing small amounts of hormones locally into the uterus. This makes the lining of the uterus thinner so you are likely to experience menstrual bleeding, and therefore reducing heavy periods.
Intrauterine devices
A hysteroscopy is done to examine the inside of your uterus, determine the cause of your abnormal uterine bleeding and sometimes perform a variety of treatments. A thin telescope is inserted into the uterus, and allows the surgeon to inspect the inside of the uterus. Some of the treatments they are able to perform include removing polyps, small fibroids or the endometrium (inner layer of the uterus).
Hysteroscopy
An endometrial ablation is used to treat very severe bleeding. It’s a surgical procedure that removes or destroys the inner layer (endometrium) of the uterus.
Endometrial Ablation
A hysterectomy is a surgical procedure where the uterus is removed. The uterus is commonly completely removed (total hysterectomy), and less commonly the uterine cervix is kept (subtotal hysterectomy). There are many different kinds of hysterectomy. Different parts of the uterus are removed for different reasons based on the individual.
Hysterectomy
A myomectomy is a surgical procedure where the fibroids are removed but the uterus remains. The procedure can be performed as open surgery (through the abdomen) or laparoscopically (key hole surgery), depending on the fibroids characteristics, such as size and position.
Myomectomy
This is a minimally invasive procedure performed by an interventional radiologist. By using a catheter and real time image, special particles are released into the uterine arteries to block the blood flow into the fibroids to shrink it.
Fibroid Embolisation
Self care
These treatments range from non-invasive like hormonal pills, to irreversible options like a hysterectomy. You and your doctor can work together to choose the treatment option that's best for your personal experience of abnormal uterine bleeding, but remember you are the one who ultimately gets to decide what treatment option is best for you.
When deciding on treatment options, some helpful things to ask may be, what are the possible side effects? What is the recovery like (if it is a surgical procedure)? What are the short and long term effects? What is the success rate of this treatment? How long can I be on this medication for?
Exercise can reduce stress which may be a contributing factor to bleeding. Exercise can also increase blood flow and relieve pain. Some gentle exercise like walking, stretching or yoga can be helpful, especially if your energy levels are low. Exercise can also aid in mood regulation.
Exercise
Supplements e.g. iron or vitamin C can affect the heaviness of bleeding and levels of energy. Always take medication as directed and speak to a doctor before taking any new medications or supplements.
Vitamins and supplements
Sometimes symptoms can be lessened with diet and nutrition changes. For example, high intakes of salt and caffeine may affect symptoms such as cramps. Eating foods high in iron such as leafy greens, beans, nuts and seeds can increase energy levels. Always consult a doctor before making any drastic changes to your diet or nutrition.
Diet and nutrition
Tracking your period can help you learn more about your body and how you might feel during certain parts of your cycle as well as monitoring what is normal or abnormal for you. It can help you to be aware of when you might have low energy, pain, heavy bleeding and more. Monitoring symptoms can also provide you with the ability to communicate to others exactly what you experience.
Period tracking app Clue.
Tracking your cycle
Applying heat to the lower abdomen for 20 minutes can relax muscles and decrease cramps e.g. hot water bottle. Over the counter pain medications may also help ease pain from cramps.
Pain management
Abnormal uterine bleeding may feel difficult to manage or isolating at times. It is important to look after your mental health just as you look after your physical health. Reach out to friends and family or a trained counsellor to talk about your experience with your period.
Reaching out for support
There are many non-medical ways to deal with symptoms of abnormal uterine bleeding, and it is important to do your own research about these methods before implementing them. Before using non-medical treatments, consider these questions to see if they are a safe option for you.
Trusted source checklist
Is the research based on evidence?
Is the advice provided by a trained professional?
Have you asked for a second opinion? It can be useful to ask for a professional opinion before making any lifestyle changes. For example, a GP will be able to tell you if taking a new supplement will have a reaction to any prescription medication you are already taking.
Self advocating in a medical environment
Going to the doctors can be a scary experience, and especially when you are going to talk about something as personal as your experience of a period. Here are some tips to help you get the most out of your doctors appointments.
Here is a link to a helpful resource from ACC with questions to get the most out of your healthcare.
When you call up to make the appointment, mention to the receptionist the reasons for the appointment. This can help make sure you get the right appointment length. If you experience pain, fatigue or other symptoms related to your period consider taking these into account when booking the time and date of your appointment.
Book the right amount of time
It may be helpful to think about what you want to say and then practise before you go to the appointment with your doctor. It might also be useful to practise some lines incase there is a moment where you feel misheard or don’t understand what your doctor is saying. For example “Could you try explaining that again..” or “it’s not quite like that, it’s more like this…”
Practice
Doctor’s appointments can sometimes be overwhelming, but bringing a trusted support person to an appointment can help you get the most out of it. They can be there to help if you find yourself feeling worried or frustrated. As well as being another set of ears and someone to take notes.
Bring a support person
If you feel unsure about the advice your doctor gave you, you have the right to look for a second opinion. You can get a second opinion even if you're just curious about other approaches.
Think about getting a second opinion
Learning about your body and what’s going on can be an empowering thing, especially in medical spaces. Understanding your own medical experience can help you stay an active decision-maker in your healthcare plan.
Keep learning
Public and private healthcare
If you see a GP (General Practitioner) about experiencing abnormal uterine bleeding, it is possible that they will refer you to see a gynaecologist or other specialist. If this happens, you may need to decide between public and private healthcare. Both are good choices and provide care from experienced specialists. Your decision should be made based on what suits your needs and circumstances.
No cost for public healthcare if you are a New Zealand citizen or permanent resident
Wait times for non-urgent cases range from weeks to months, depending on the severity of the case. Most people will be seen within a year of a referral. Urgent cases may be seen sooner.
Immediate treatment for life threatening conditions or injuries
May be better equipped to handle more complex cases
You are seen by the first available doctor
Public
45 minute initial appointment costs range from approximately $250 to $350 with no health insurance
Very short or no wait time
Practices may be smaller and have fewer resources than public facilities
You can choose your own practice and doctor
Private practice professionals often have more continuity of care
Private