title: Medical management of heavy menstrual bleeding.
abstract: Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life. The role of the clinician is to provide information to facilitate women in making an appropriate choice. Unfortunately, many options can be associated with hormonal side effects, prevention of fertility and lack of efficacy, leading to discontinuation and progression to surgical interventions. Herein, we discuss the various options currently available to women, including antifibrinolytics, nonsteroidal anti-inflammatory preparations, oral contraceptive pills and oral, injectable and intrauterine progestogens. In addition, we describe the more novel option of selective progesterone receptor modulators and their current benefits and limitations.
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, EH16 4TJ, UK.
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Maybin
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, EH16 4TJ, UK.
authors.forename: Hilary O D
authors.initials: HO
authors.lastname: Critchley
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000706:statistics & numerical data; D016912:Levonorgestrel / Q000627:therapeutic use; D008525:Medroxyprogesterone / Q000627:therapeutic use; D008595:Menorrhagia / Q000188:drug therapy* / Q000503:physiopathology; D009640:Norethindrone / Q000627:therapeutic use; D011374:Progesterone / Q000627:therapeutic use; D011788:Quality of Life; D016387:Women's Health
chemical_list: D000933:Antifibrinolytic Agents; D003278:Contraceptives, Oral, Hormonal; D011374:Progesterone; D016912:Levonorgestrel; D008525:Medroxyprogesterone; D009640:Norethindrone
keywords: SPRM; adenomyosis; endometrial; endometrium; estradiol; fibroid; menorrhagia; menstruation; polyps; progesterone