Non-hormonal options
Two kinds of medicine reduce heavy bleeding without hormones. Both are taken only on bleeding days, so they suit people who want to avoid hormones or are trying to become pregnant.
Tranexamic acid
A pill taken during your period, typically for up to five days. It slows the breakdown of blood clots in the uterine lining and can reduce blood loss by roughly a third to a half. It is generally not used by people with a current or past blood clot. It needs caution with estrogen-containing birth control. Your physician will review your history before prescribing it.
NSAIDs
Anti-inflammatory medicines such as ibuprofen, naproxen, and mefenamic acid lower the prostaglandins that drive bleeding and cramps. Started on the first day of bleeding, they reduce blood loss modestly and ease pain. Avoid them if you have a bleeding disorder, kidney disease, a stomach ulcer, or take a blood thinner.
Combining treatments
Non-hormonal medicines can be combined with other approaches. Your physician will tell you which combinations are safe for you.
Sources
- American College of Obstetricians and Gynecologists. Practice Bulletin No. 128: Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012;120(1):197–206 (reaffirmed).
- American College of Obstetricians and Gynecologists. Committee Opinion No. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Obstet Gynecol. 2013;121(4):891–896 (reaffirmed).