Hormonal Therapy for Heavy Menstrual Bleeding

The goals of treatment of heavy menstrual bleeding are to reduce morbidity, restore and maintain normal blood volumes, prevent life-threatening hemorrhage, and improve quality of life. Hormonal therapies are safe and effective and are the mainstay of the treatment of heavy menstrual bleeding in adolescent females. Typically, hormonal therapies used to treat acute heavy menstrual bleeding include intravenous conjugated equine estrogen, combined oral estrogen-progestin pills, and oral progestins. Once the acute bleeding has been controlled, multiple hormonal therapy options exist for long-term maintenance of heavy menstrual bleeding. These hormonal therapies include the levonorgestrel intrauterine system (LNG-IUS), combined hormonal options, and oral/injectable/subdermal progestins.