A hormonal intrauterine device—which releases the hormone progestin—can be “very effective in reducing bleeding,” says Dr. Yang. In fact, one hormonal IUD currently on the market—Mirena—has even been FDA-approved for the treatment of heavy periods.
It’s common for women to have irregular periods and spotting for the first few months after getting an IUD inserted, but those side effects don’t usually last long-term. Some women with hormonal IUDs stop having periods completely. Like birth control pills, an IUD only makes sense if you’re not looking to get pregnant any time soon.
This procedure is less invasive than uterine surgeries, but it can still help some women with heavy menstrual bleeding. “The way it works is it burns away the lining of the uterus so that with each subsequent period, the flow is lighter,” says Dr. Yang. “In some women, they may not have a period at all.”
In terms of reduced blood flow, results from endometrial ablation are similar to those of hormone-releasing IUDs, says Dr. Yang. The procedure can be done with heat, radio waves, microwave energy, or even electric current. Cryoablation, in which endometrial tissue is frozen off, may also be an option. You may not be able to get pregnant after an endometrial ablation.
Myomectomy or hysterectomy
Women who don’t have success with medication or less invasive treatment options may consider having part or all of their uterus removed. This is sometimes the case for women with uterine fibroids or other structural causes of heavy bleeding.
“Some women may be candidates for myomectomy procedures, where we remove the fibroids while still preserving the uterus,” says Dr. As-Sanie. Women can still become pregnant after undergoing a myomectomy, although it can increase the risk of pregnancy or childbirth complications.
A full hysterectomy is the only 100% cure for heavy bleeding and other menstrual symptoms, says Dr. As-Sanie, but it’s often considered a last resort. Pregnancy is not possible after having a hysterectomy, and women who undergo it will enter early menopause.
“This is an option women may choose to proceed with if they don’t respond to other treatments and have continued severe symptoms that are disruptive and impact their quality of life,” says Dr. Yang. Doctors may also recommend a hysterectomy for women whose bleeding is so heavy that they become anemic and require blood transfusions, she adds.
The bottom line
Women whose lives are disrupted by heavy periods should not suffer in silence, says Dr. As-Sanie. “There’s a lot of stigma and minimizing of symptoms out there,” she says. “You might think, ‘Oh this is normal, deal with this.’ Some doctors may not even recognize this as a serious and treatable condition.”
But finding a doctor who will help address your concerns is important, she adds. “You don’t have to get to the point of being anemic or not leaving your house before you can get help,” she says. “There are a lot of really effective and safe treatments, so I encourage women to talk to their doctors—and moms to talk to their daughters—because you really don’t have to live this way.”