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Painful Periods

Most women experience pain and cramping at some point during their periods. For some though, that pain can be debilitating. Sometimes controlling your period can help control your pain. Once you have had an appropriate evaluation, and we are sure there is nothing physically wrong, you have the option to choose how to manage your pain. You may choose to do nothing or you can try a variety of options to help minimize or eliminate your pain.

Heavy periods can be more painful. In addition, if the bleeding is heavy then you may become anemic. A low blood count is a reason to do something. If you elect to do nothing then you will need yearly evaluation until the bleeding eventually stops when you go into menopause. The average age of menopause is 51.

Medications

The following are medications typically used for contraception but also work to help control bleeding.

  • Birth control – estrogen and progesterone: Birth control pills, the patch and the vaginal ring offer the best chance of period management with the fewest side effects. Any method, and any pill should do to help manage your periods. Women older than 35 who smoke should not take birth control pills. There are other reasons, as well, why women will not or should not take birth control pills. You should have that conversation with a doctor before starting any medication.
  • Depo Provera: This is a shot which can make periods disappear. You get the shot once every three months. It may take up to 9 months before there is NO menstrual bleeding. In the meanwhile, many women have daily spotting (no need for a pad). A common misconception is that it is not safe for women to have no periods but in fact it is safe for women to have no periods while taking DepoProvera. You can read more on that topic at http://www.depo-provera.com.
  • IUD with progesterone (Mirena): This is form of contraception is an intrauterine or IUD device which can help regulate bleeding. Progesterone is the medicine in this IUD, the medicine in the Depo Provera shot and it is ½ of the medicine in the birth control pill.  Progesterone makes the cells which line the uterus STOP growing. The less they grow, the lighter the periods. Mirena may not work as well or as quickly as Depo Provera, but it has almost no side effects. Learn more at http://www.mirena-us.com/

Medicine Which is NOT Contraceptive

  • Progesterone Pills: These progesterone pills are not contraceptive. Taken daily, progesterone makes the cells which line the inside of the uterus stop growing. Provera is very effective in stopping a heavy period here and now. Some women do not like the way it makes them feel, which limits its use. There is usually no problem with MPA (medroxyprogesterone) in patients who smoke or have high blood pressure or headaches…[read more]

Surgery and More

These procedures may provide temporary or permanent solutions to your bleeding.

  • Leuprolide Acetate: This is a medicine given by injection. It is a Temporary hormonal solution to the bleeding. Leuprolide is like DepProvera, but stronger. Leuprolide causes a temporary menopause, which makes your estrogen level drop really low. Since estrogen causes most of the bleeding, a lack of estrogen fixes most bleeding. This medicine is Not a long term solution. Leuprolide is used to stop the bleeding in preparation for surgery or to stop the bleeding while we figure out what to do next. Leuprolide does not work for women already in menopause…[read more]
  • Endometrial Resection with Ablation: This is a surgery which removes the cells that line the uterus. It is like a deeper D&C. This is an outpatient procedure and you will go home from the hospital the same day. This surgery cures approximately 70% of women of heavy bleeding. If this does not work then you may need to consider a hysterectomy…[read more]
  • Hysterectomy: This is a surgery to remove the uterus, but does not remove the ovaries, thus you will no longer be able to get pregnant. Hysterectomy is a 100% cure for the bleeding.

ADDITIONAL TOPICS

Menopause

Always feel like the hot one in the room? You’re not alone. Menopause doesn’t have to be a struggle….[read more]

Pain

Pain “down there” can be caused by a number of reasons. You deserve to be pain free. Here is helpful information about what might be causing pain…[read more]

Contraception

Your options for contraception are more than just a daily pill. Hormonal contraception includes a pill, shot, IUD and more…[read more]