The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.

Menorrhagia and amenorrhea may be treated with hormonal and nonhormonal agents and therapies. These may include the following:

Prescription Medications for Menorrhagia (Heavy Bleeding)

Antihemorrhagic

  • Tranexamic acid (not generally available in the US)

Oral Synthetic Progestins

  • Medroxyprogesterone (Provera, Amen, Curretab, Cycrin, Depo-Provera)
  • Norethindrone acetate (Aygestin)
  • Norgestrel (Ovral)

Natural Progestins

  • Progesterone (Prometrium)

Progestin-containing Intrauterine Device

  • Levonorgestrel-releasing intrauterine system (Progestasert, Mirena)

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

  • Ibuprofin (Motrin)
  • Naproxen (Naprosyn, Anaprox)
  • Ponstan, Ponstel

Gonadotrophin Inhibitors

  • Danazol (Danocrine)

Over-the-Counter Medications for Menorrhagia

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

  • Ibuprofen (Advil, Motrin, Midol PMS)
  • Naproxen (Aleve, Naprosyn, Naprelan, Anaprox)

Prescription Medications for Amenorrhea (Lack of Menstruation)

Estrogen Replacement Therapy

  • Conjugated Equine Estrogens (Premarin, Premarin Vaginal Cream)
  • Synthetic Conjugated Estrogens (Cenestin)
  • Esterified Estrogens (Estratab, Menest)
  • Estropipate (Ortho-Est, Ogen, Ogen Vaginal Cream)
  • Micronized 17-beta estradiol (Estrace; Matrix Patch: Alora, Climara, Esclim, Vivelle, Vivelle-Dot; Reservoir Patch: Estraderm; Estrace Vaginal Cream, Estring Vaginal Ring)
  • Estradiol Hemihydrate (Vagifem Vaginal Tablet)

Progestogen

  • Progestin Oral Tablet
  • Progestin Injectable
  • Progestin IUD
  • Progesterone Oral Capsule
  • Progesterone: Vaginal Gel
  • Progesterone IUD

Estrogen Plus Progestogen (HRT)

  • Oral, Continuous Cycle
  • Oral, Continuous-combined
  • Oral, Intermittent-combined
  • Skin Patch, Continuous Cycle
  • Skin Patch, Continuous-combined

Combination Estrogen/Progestin Contraceptive Pills

  • Desogestrel/estradiol (Desogen, Mircette, Ortho-Cept)
  • Drospirenone/estradiol (Yasmin)
  • Ethynodiol/estradiol (Demulen, Zovia)
  • Gestodene/estradiol (Minesse)
  • Levonorgestrel/estradiol (Alesse, Levlen, Levlite, Nordette, Tri-Norinyl, Triphasil)
  • Norethindrone acetate/estradiol (Estrostep, Loestrin)
  • Norethindrone/estradiol (Brevicon, Estrostep, Genora, Intercon, Jenest, ModiCon, Necon, NEE Nelova, Norethrin, Norinyl, Ortho-Novum, Ovcon, Tri-Norinyl)
  • Norethindrone/ Mestranol (Intercon, Necon, Nelova, Norethrin, Ortho-Novum)
  • Norgestimate/estradiol (Ortho-Cyclen, Ortho Tri-Cyclen)
  • Norgestrel/estradiol (Lo/Ovral)

Anti-hyperprolactinemic

  • Bromocriptine

Prescription Medications for Menorrhagia

Antihemorrhagic

Common names include:

  • Tranexamic acid (not generally available in the US)

Tranexamic acid is a very effective drug that enhances blood clotting. It is used more in Europe than in the United States.

Possible side effects include:

  • Diarrhea
  • Nausea or vomiting
  • Discomfort during menstruation
  • Watery eyes
  • Color-blindness (unproven)

Oral Synthetic Progestins

Common names include:

  • Medroxyprogesterone (Provera, Amen, Curretab, Cycrin, Depo-Provera)
  • Norethindrone acetate (Aygestin, Norlutate)
  • Norgestrel/estradiol (Ovral)

Oral synthetic progestins are taken during the premenstrual phase of the menstrual cycle and help prevent heavy bleeding. They are most effective when taken for 21 days of each cycle.

Possible side effects include:

  • Weight gain
  • Mood changes
  • Breast tenderness
  • Headaches
  • Acne
  • Unpredictable spotting

Natural Progestins

Common names include:

  • Progesterone (Prometrium)

Natural progestins may be helpful in reducing heavy bleeding and have few side effects. They may be taken orally or as a vaginal gel.

Progestin-containing Intrauterine Device

Common names include:

  • Levonorgestrel-releasing intrauterine system (Progestasert, Mirena)

Levonorgestrel-releasing intrauterine system (Progestasert, Mirena) may be used for up to seven years and helps to reduce heavy bleeding. It releases progestin mainly into the uterus and cervix and can be a good alternative to hysterectomy.

Possible side effects include:

  • Irregular bleeding during the first six months
  • Nausea
  • Bloating

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names include:

  • Ibuprofin (Motrin)
  • Naproxen (Naprosyn, Anaprox)
  • Ponstan, Ponstel

See the information below, in the over-the-counter medication section.

Gonadotrophin Inhibitors

Common names include:

  • Danazol (Danocrine)

Gonadotrophin inhibitors are usually used to stop heavy bleeding in severe cases. Danazol may cause your skin to be more sensitive to sunlight.

Possible side effects include:

  • Decrease in breast size
  • Irregular menstrual periods
  • Weight gain
  • Flushing of skin
  • Mood changes
  • Nervousness

Over-the-Counter Medications for Menorrhagia

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names include:

  • Ibuprofen (Advil, Motrin, Midol PMS)
  • Naproxen (Aleve, Naprosyn, Naprelan, Anaprox)

Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce heavy bleeding by blocking prostaglandins, which are substances that increase uterine contractions, and reducing inflammation. They are reported to reduce the loss of menstrual blood by 25%-35%.

These same medications can also be prescribed, in a higher dose per capsule. Another prescription medication in this class is Ponstan or Ponstel.

Possible side effects include:

  • Stomach pain, cramps, or discomfort
  • Heartburn
  • Indigestion
  • Nausea and vomiting

Prescription Medications for Amenorrhea (Lack of Menstruation)

If medications are prescribed to treat amenorrhea, they will be used to treat the underlying causes. If the causes of amenorrhea relate to hormone imbalance, it may be treated with hormone replacement therapy. Amenorrhea related to polycystic ovary syndrome is usually treated with birth control pills. If the underlying cause is a pituitary tumor, it may be treated with a drug that reduces the secretion of the hormone prolactin.

Prescription Medications for Amenorrhea

Estrogen Replacement Therapy (ERT)

Common names include:

  • Conjugated Equine Estrogens (Premarin, Premarin Vaginal Cream)
  • Synthetic Conjugated Estrogens (Cenestin)
  • Esterified Estrogens (Estratab, Menest)
  • Estropipate (Ortho-Est, Ogen, Ogen Vaginal Cream)
  • Micronized 17-beta estradiol (Estrace; Matrix Patch: Alora, Climara, Esclim, Vivelle, Vivelle-Dot; Reservoir Patch: Estraderm; Estrace Vaginal Cream, Estring Vaginal Ring)
  • Estradiol Hemihydrate (Vagifem Vaginal Tablet)

Estrogen may be administered as an oral tablet, skin patch, injection, pellet placed under the skin, or as a vaginal cream, ring, or tablet. In general, you should not use ERT if you are or may be pregnant, have a family history of breast cancer or other hormone-sensitive cancer, have unexplained bleeding from your uterus, or have a family history of blot clotting disorders. You should discuss the risks and benefits of ERT with your healthcare provider.

Possible side effects include:

  • Uterine bleeding
  • Sore breasts
  • Abdominal bloating
  • Nausea
  • Fluid retention
  • Headache, including migraine
  • Dizziness
  • Corneal changes in the eye

Progestogen

Progestin Oral Tablet

  • Medroxyprogesterone acetate (Amen, Cycrin, Provera)
  • Norethindrone (Micronor, Nor-QD)
  • Norethindrone acetate (Aygestin)
  • Norgestrel (Ovrette)
  • Levonorgestrel (Norplant)
  • Megestrol Acetate (Megace)

Progestin Injectable

  • Medroxyprogesterone acetate (Depro-Provera)

Progestin IUD

  • Levonorgestrel (Mirena)

Progesterone Oral Capsule

  • Progesterone USP (Prometrium)

Progesterone: Vaginal Gel

  • Progesterone (Crinone)

Progesterone IUD

  • Progesterone (Progestasert)

If you choose ERT, progesterone must also be taken to reduce the increased risk of uterine cancer from taking ERT alone. Progesterone or progestin (synthetic progesterone) is available as replacement therapy.

Possible side effects include:

  • Fluid retention
  • Weight gain
  • Headache
  • Mood changes

Hormone Replacement Therapy (HRT)

Estrogen Plus Progestogen

  • Oral, Continuous Cycle:
    • Conjugated Equine Estrogens and Medroxyprogesterone Acetate (Premphase)
  • Oral, Continuous-combined:
    • Conjugated Equine Estrogens and Medroxyprogesterone Acetate (Prempro)
    • Ethinyl Estradiol and Norethindrone Acetate (Femhrt)
    • 17-Beta Estradiol and Norethindrone Acetate (Activella)
  • Oral, Intermittent-combined:
    • 17-Beta Estradiol and Norgestimate (Ortho-Prefest)
  • Skin Patch, Continuous Cycle
    • 17-Beta-Estradiol and Norethindrone Acetate (CombiPatch)
  • Skin Patch, Continuous-combined
    • 17-Beta-Estradiol and Norethindrone Acetate (CombiPatch)

When progesterone is taken with estrogen, it is called hormone replacement therapy (HRT). There are various options for HRT, and your healthcare provider can help you to explore which one might be best for you. Options for HRT include cyclic, continuous-cyclic, continuous-combined, and intermittent-combined.

Possible side effects include:

  • Uterine bleeding or “spotting”
  • Fluid retention
  • Sore breasts
  • Headache
  • Mood changes

Combination Estrogen/Progestin Contraceptive Pills

Common names include:

  • Desogestrel/estradiol (Desogen, Mircette, Ortho-Cept)
  • Drospirenone/estradiol (Yasmin)
  • Ethynodiol/estradiol (Demulen, Zovia)
  • Gestodene/estradiol (Minesse)
  • Levonorgestrel/estradiol (Alesse, Levlen, Levlite, Nordette, Tri-Norinyl, Triphasil)
  • Norethindrone acetate/estradiol (Estrostep, Loestrin)
  • Norethindrone/estradiol (Brevicon, Estrostep, Genora, Intercon, Jenest, ModiCon, Necon, NEE Nelova, Norethrin, Norinyl, Ortho-Novum, Ovcon, Tri-Norinyl)
  • Norethindrone/Mestranol (Intercon, Necon, Nelova, Norethrin, Ortho-Novum)
  • Norgestimate/estradiol (Ortho-Cyclen, Ortho Tri-Cyclen)
  • Norgestrel/estradiol (Lo/Ovral)

Birth control pills are often used to treat polycystic ovary syndrome, which may be an underlying cause of amenorrhea.

Possible side effects include:

  • Abdominal pain
  • Nausea
  • Swelling
  • Weight gain
  • Mood changes
  • Breast tenderness
  • Spotting between periods

Anti-hyperprolactinemics

Common names include:

  • Bromocriptine

Bromocriptine is used to treat amenorrhea that relates to excessive secretions of the hormone prolactin, seen with pituitary tumors. You should use some form of birth control while you are taking bromocriptine.

Possible side effects include:

  • Dizziness or lightheadedness, especially upon standing
  • Nausea

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your healthcare provider.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your healthcare provider.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.