Dear Mayo Clinic: After almost a year of having a period that is much heavier than normal, my gynecologist recommended an IUD as treatment. How does this work, and is it safe? I am 38, and I'm done having children, but don't need contraception.
A: Many types of intrauterine devices, or IUDs, are available. The specific kind that has been approved by the U.S. Food and Drug Administration for treatment of heavy menses releases the hormone progestin. This type of IUD is safe and highly effective for easing periods that are heavier than normal. IUDs are not the only option for treating this condition though. Before you move forward, consider talking with your doctor about the range of treatment choices available to you.
Hormonal IUDs are small, T-shaped plastic devices placed in the uterus that release progestin over time. Typically, IUDs are used to prevent pregnancy. But, research has shown hormonal IUDs to be useful for easing heavy periods, too. That's because they not only thicken cervical mucus to prevent sperm from reaching or fertilizing an egg, they also thin the lining of the uterus. That decreases menstrual blood flow and cramping.
One of the main benefits of using an IUD to reduce heavy periods is that, once placed, an IUD is effective for three to five years. The exact amount of time it can be left in place depends on the brand you choose. Little, if any, follow-up care is needed to manage the IUD during that time.
Side effects usually are minimal. Some women may notice headaches, acne, breast tenderness, mood changes and weight gain when they are using a hormonal IUD. There is a small risk of tearing the uterus when the IUD is placed. But, that's rare, particularly when the procedure is performed by an experienced physician.
If you prefer not to have an IUD, or if you would like to explore other possible treatment options, there are alternatives. Some women take birth control pills to manage heavy menstrual bleeding. This also can be an effective treatment. Keep in mind, however, that taking the pill is not a good choice if you smoke. Your doctor should review your medical and family history before you start taking birth control pills to make sure you're an appropriate candidate for them.
If, as in your situation, birth control is not needed, another option for controlling menstrual bleeding is to take a pill 10 to 12 times a month that contains only progestin. The medication reduces bleeding by correcting the hormone imbalance that usually contributes to heavy periods.
If treatment with an IUD or medication is not successful, a variety of surgical options also can be used to decrease menstrual blood flow. Most of these procedures can be done on an outpatient basis and do not require an overnight hospital stay.
Before you make a decision, it would be a good idea to take time to review all the possible treatment options with your doctor. Talk about your preferences, and discuss your medical and family background. Go over the risks and benefits of each option. That conversation can help you get a better idea of the treatment choice that's right for you and help you find the one that best fits your situation.
