Tranexamic acid, nonsteroidal anti-inflammatory drugs (NSAIDs), birth control pills, or progesterone agents may be used to treat heavy menstrual bleeding, however these treatments do not reduce the size of uterine fibroids.

Tranexamic acid reduces heavy periods by enhancing the body’s clotting ability. Rare but serious side effects such as deep venous thrombosis (DVT) and pulmonary embolism (clots in the lung) may occur. Therefore, it is not recommended for women with an increased risk of arterial or venous thrombosis.

NSAIDs are mainly used for period pain, but are not as effective as tranexamic acid for heavy periods.

Combined birth control pills are commonly prescribed for heavy menstrual periods. As fibroid growth is dependent on oestrogen, fibroid growth showed be monitored. A progestogen-only pill can also be used to control heavy periods.

Gonadotropin-releasing hormone (GnRH) agonists can be used to induce temporary menopause, so as to reduce blood supply and shrink fibroids. They are usually used for 3 – 6 months prior to fibroid surgery. Common side effects include hot flashes, mood changes and osteoporosis. Use is generally limited to six months and fibroids usually regrow after GnRH agonists are stopped.

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