Medications for Menstrual Disorders

Here are the basics about each of the medicines below. Only common problems with them are listed.

Prescription Medicines for Heavy Bleeding (Menorrhagia)

Antihemorrhagic

Common name: tranexamic acid

This medicine may be given to lessen menstrual flow and cramps.

Problems may be:

  • Headache
  • Sinus and nasal problems
  • Belly pain
  • Muscle and joint pain
  • Muscle cramps
  • Anemia
  • Fatigue

Oral Progestogens

Oral progestins are taken during the premenstrual phase of the menstrual cycle. They can help prevent heavy bleeding. They are most helpful when taken for 21 days of each cycle.

Common names are:

  • Medroxyprogesterone
  • Norethindrone acetate
  • Norgestrel/estradiol
  • Natural progesterone

Problems may be:

  • Weight gain
  • Mood changes
  • Breast tenderness
  • Headaches
  • Acne
  • Spotting

Progestin-Containing Intrauterine Device (IUD)

Common name: levonorgestrel-releasing IUD system

An IUD may be used for up to five years. It helps reduce heavy bleeding. It releases progestin mainly into the uterus and cervix.

Problems may be:

  • Irregular bleeding during the first six months
  • Nausea
  • Bloating

Over the Counter Medicines for Heavy Bleeding (Menorrhagia)

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names are:

  • Ibuprofen
  • Naproxen sodium

Certain NSAIDs can lessen heavy bleeding and ease swelling.

Problems may be:

  • Belly pain, cramps, or discomfort
  • Heartburn
  • Indigestion
  • Nausea and vomiting

Prescription Medicines for Secondary Amenorrhea

Amenorrhea due to lack of estrogen and progesterone may be treated with hormone replacement therapy (HRT). Amenorrhea due to polycystic ovary syndrome (PCOS) is often treated with birth control pills. Amenorrhea due to a pituitary tumor may be treated with a drug to reduce the secretion of the hormone prolactin.

Prescription Medicines for Amenorrhea

Combination Birth Control Pills

Common names are:

  • Desogestrel/estradiol
  • Ethynodiol/estradiol
  • Gestodene/estradiol
  • Levonorgestrel/estradiol
  • Norethindrone acetate/estradiol
  • Norethindrone/estradiol
  • Norethindrone/mestranol
  • Norgestimate/estradiol
  • Norgestrel/estradiol

Birth control pills are often used to treat PCOS. This may be an underlying cause of amenorrhea or oligomenorrhea (too few periods).

Problems may be:

  • Belly pain
  • Nausea
  • Swelling
  • Weight gain
  • Mood changes
  • Breast tenderness
  • Spotting between periods

Progestogen

Progestogen is available in many forms, such as oral pills, injections, IUD, and vaginal gel. Common names are:

  • Oral pills—medroxyprogesterone acetate, norethindrone, levonorgestrel, megestrol acetate
  • Injection—medroxyprogesterone acetate
  • IUD—levonorgestrel
  • Vaginal gel—progesterone

Progestogen may be used when the ovaries are producing estrogen. Women with an intact uterus who choose estrogen replacement therapy (ERT) must also take it. It can lower the risk of uterine cancer from taking ERT alone. Progesterone or progestin (synthetic progesterone) is available as replacement therapy.

Problems may be:

  • Fluid retention
  • Weight gain
  • Headache
  • Mood changes

Hormone Replacement Therapy (HRT)

Common names are:

  • Oral pills (may be one pill or two separate pills of estrogen and progesterone)—conjugated equine estrogens and medroxyprogesterone acetate, conjugated equine estrogens and medroxyprogesterone acetate, ethinyl estradiol and norethindrone acetate, 17-beta estradiol and norethindrone acetate
  • Skin patch—17-beta-estradiol and norethindrone acetate

Birth control pills are the most common treatment, but some healthcare providers suggest using HRT (estrogen and progesterone) for women with health problems like premature ovarian failure.

Problems may be:

  • Uterine bleeding or spotting
  • Fluid retention
  • Sore breasts
  • Headache
  • Mood changes

Anti-hyperprolactinemics

Common names are:

  • Bromocriptine
  • Cabergoline

These medicines are used to treat amenorrhea that is due to excessive secretions of the hormone prolactin, a hormone related to pituitary tumors. Birth control should be used when taking this medicine.

Problems may be:

  • Lightheadedness, especially upon standing
  • Nausea

References

Abnormal uterine bleeding. EBSCO DynaMed website. Available at: http://www.dynamed.... Updated October 10, 2019. Accessed November 14, 2019.
Amenorrhea. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/abnormal-uterine-bleeding. Updated January 16, 2018. Accessed November 14, 2019.
Bleeding Disorders in Women. US Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/ncbddd/blooddisorders/women/index.html. Updated April 25, 2018. Accessed November 14, 2019.
Klein DA, Poth MA. Amenorrhea: an approach to diagnosis and management. Am Fam Physician. 2013 Jun 1;87(11):781-788.
Last reviewed September 2019 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG
Last Updated: 1/15/2020

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