How you treat abnormal uterine bleeding depends on the cause. Sometimes the underlying cause cannot be cured. Treatment may focus on reducing symptoms to improve overall quality of life.

In other cases, a cure may be possible, but it may come with side effects like the inability to become pregnant.

Often, a doctor will start with treatment options like medication before considering more involved treatments like surgery. But every person is different.

Here are all the treatment options available for both acute bleeding— which comes on suddenly— and chronic bleeding — which has been going on for some time.

Intravenous (IV) conjugated equine estrogen

This treatment may be given if a doctor cannot find any other cause of your bleeding and assumes that you have a hormonal imbalance.

Often under the brand name Premarin, this medication contains estrogen hormones, including those found in horses, and is injected into the body.

Conjugated equine estrogen can only be used short term and works to stop abnormal bleeding by quickly and temporarily boosting estrogen levels.

Combination birth control pills

Combination birth control pills are a common treatment for acute abnormal uterine bleeding related to ovulation or conditions like polycystic ovary syndrome (PCOS).

These pills use synthetic estrogen and progesterone to help regulate the menstrual cycle and reduce how much you’re bleeding.

These pills can be used in the longer term and are often taken for 21 days, followed by a pill-free week where there’ll be a withdrawal bleed. Some people may take them continuously to stop bleeding completely.

According to one 2006 study, 88% of study participants who took combination birth control pills had no bleeding within 3 days on average.

Other research highlighted in a 2019 literature review article showed that combination birth control pills lead to a 35% to 69% reduction in bleeding.

Oral progestin therapy

For those who cannot receive hormonal treatments containing estrogen, oral progestin therapy may be offered.

It works similarly to the above in terms of regulating the menstrual cycle but does not have side effects like abnormally thickening the uterine lining.

It’s common to only take oral progestin therapy on certain days of the menstrual cycle, potentially reducing bleeding by more than 80%.

But there is a risk of side effects like blood loss becoming more irregular.

GnRH agonists

Gonadotropin-releasing hormone (GnRH) agonists work to turn off GnRH in the body, temporarily stopping the menstrual cycle.

These drugs can only be taken for a short period of time — usually less than 6 months — according to the American College of Obstetricians and Gynecologists (ACOG) due to potential adverse effects like losing bone mineral density.

Because of that, they’re often considered when other treatments have failed or are not an option.

GnRH agonists can be used to treat fibroid-related bleeding as well as other types of acute uterine bleeding and work by reducing fibroid size.

But the effect does not last forever. Once you stop taking the drug, the fibroids can begin growing again.

Medroxyprogesterone acetate

Medroxyprogesterone acetate pills treat hormonal conditions like endometriosis or PCOS.

They’re often prescribed for 2 to 3 months and reduce abnormal uterine bleeding by stopping the uterine lining from thickening before a period.

Tranexamic acid

Tranexamic acid can be taken orally or by IV. If taken as a pill, it’s swallowed at the start of a period each month.

Often, it’s taken for a few days in a row and may be taken more than once a day if needed as determined by your doctor. It stops blood clots from breaking down in the body, reducing bleeding during menstruation.

Intrauterine tamponade

An intrauterine tamponade is an entirely different treatment from the rest.

It’s a balloon that attaches to a catheter and is inserted deep into the vaginal canal until it reaches inside the uterus. It’s gently filled with saline and inflated until it compresses the blood vessels.

The balloon may be left inside for up to 24 hours to control acute bleeding and is a more common treatment for emergencies such as postpartum hemorrhage.

Hormonal IUD

If you do not want to become pregnant at all or any time soon, a hormonal IUD placed in the uterus can help with ongoing bleeding.

It’s similar to some of the acute bleeding treatment options in that it contains a synthetic version of the progesterone hormone.

The T-shaped plastic device stops fertilization by thickening mucus in the cervix and thinning the uterine lining.

Research has found that a hormonal IUD can reduce blood loss by 71% to 95%, making it a highly effective option for many. For some people, bleeding may stop completely after a year of having the IUD.

Potential side effects include irregular bleeding for up to 6 months after insertion. On the plus side, hormonal IUDs can remain inside your body for several years — between 3 and 8 — depending on the brand, according to Planned Parenthood.

Monthly or extended-cycle birth control pills

Birth control pills can regulate the menstrual cycle and reduce menstrual bleeding, providing relief for more chronic problems. These can be combined, containing both estrogen and progestin.

Typically, you’ll take them for 3 weeks and then have a pill-free week where you’ll experience a withdrawal bleed.

But there is the option to take them continuously to reduce how often you’re experiencing withdrawal bleeding.

A healthcare professional can help determine the best option for you and your lifestyle.

Oral or intramuscular progestin therapy

If you’re unable to take a combined pill, one that contains just progestin is an option.

These are taken for 21 days each month on specific days of your menstrual cycle to regulate it and limit blood loss by up to 80%.

Alternatively, the progestin contraceptive can be injected into the body every 3 months.

Tranexamic acid

Tranexamic acid can reduce bleeding by preventing the breakdown of blood clots. This treatment can be taken by mouth or IV, typically at the start of each menstrual period.

Unlike other medical treatments for chronic bleeding, which may act as a contraceptive, tranexamic acid is safe to take if you are trying to conceive.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (also known as NSAIDs) have been found to reduce heavy menstrual bleeding by 25% to 35% in up to 75% of people who take them.

People who have bleeding disorders should steer clear of these drugs as they can increase the risk of bleeding by affecting platelet function.

NSAIDs include pain relievers like ibuprofen. They block hormone-like compounds called prostaglandins. Too many of these can contribute to heavy bleeding. They’re only used during a menstrual period.


Surgery is also an option for severe cases of abnormal uterine bleeding.

A hysteroscopy is a narrow tube with a camera inside that’s inserted into the womb through the vagina. It can be used to investigate and diagnose problems, and it can also treat bleeding caused by fibroids or polyps.

This occurs by passing surgical instruments through the tube that are used to remove the fibroids or polyps. The procedure tends to be short, lasting up to an hour.

You can usually go home soon after, as you’ll be awake during it but may be given an anesthetic.

Dilation and curettage (D&C)

D&C involves expanding the cervix and removing any abnormal tissue by scraping the lining of the uterus with a spoon-shaped instrument.

The likes of fibroids or noncancerous tumors that may be contributing to bleeding can also be removed during the procedure.

After a few hours, you’ll be able to go home and can usually return to typical activities within a couple of days.

Uterine artery embolization

Uterine artery embolization stops blood flow into the uterus by blocking blood vessels. This inhibits the growth of the fibroids and causes them to shrink.

It’s carried out by inserting a catheter into an artery in the leg. You’ll be given a sedative and local anesthesia, so you’re not in pain. You may need to stay in the hospital overnight.

According to the ACOG, around 3 in 4 people experience a reduction in symptoms afterward, though this can take 2 to 3 months.

But 1 in 5 people may need more surgery in the future.


A myomectomy is often performed to remove fibroids, so it can help with bleeding linked to these growths. However, more than one procedure may be needed as fibroids can regrow.

This may be a good option for people who want to become pregnant, as the uterus is left intact.

Depending on how big your fibroids are and where they are, a myomectomy may involve small incisions in your stomach or one bigger incision.

The recovery period can last a few weeks, though you’ll usually be home within a few days.

Endometrial ablation

Destroying the lining of the uterus, endometrial ablation is not suitable for people who want to become pregnant in the future.

While you may still be able to conceive, there is a higher risk of serious complications. So long-term birth control is advised.

This surgery is less invasive than the likes of a hysterectomy, and you can often go home on the same day.

There are various ways to perform the procedure, including via radiofrequency, electrosurgery, or a heated balloon.

Older research showed that it’s typically successful in cases of acute abnormal uterine bleeding and often results in lighter periods or no periods at all. But other symptoms like pain may still be present.


A hysterectomy is often a last resort when other treatments have failed, as it removes the uterus entirely.

It can be performed vaginally or abdominally and is highly effective at reducing bleeding due to the likes of fibroids or adenomyosis.

But there’s typically a longer recovery period of several weeks. After a hysterectomy, you will also no longer have periods or be able to become pregnant.

The best treatment option for you will depend on a few factors, such as:

  • the severity of your symptoms
  • the underlying cause
  • what you have already tried
  • whether you would like to become pregnant in the future

Often, healthcare professionals will opt for medications before recommending the surgical route. But know that there are several options available for abnormal uterine bleeding, and your clinician will be able to advise what’s right for you.

Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.