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There are various treatment options available for women who have very heavy periods, including medication, hormonal contraceptives and surgery. Knowing about the advantages and disadvantages of each option can help make it easier to choose an appropriate treatment.If very heavy periods become too much of a problem, treatment can help you to cope better. Different types of medication can reduce the bleeding and related problems. If one medication doesn't work, it is usually possible to try out other kinds.Hormonal contraceptives like birth control pills or intrauterine devices (IUDs) affect the menstrual cycle and lessen the amount of bleeding. Any fibroids or polyps that are found to be the cause can be surgically removed. If the effects of heavy periods are particularly bad, other procedures can be considered.The choice of treatment and best time for treatment will depend on whether a woman is planning to become pregnant. The most effective treatments all limit a woman's ability to get pregnant – either temporarily, like the pill, or permanently, like the surgical removal of the womb (hysterectomy).But as long as the heavy periods aren’t causing anemia, they don’t necessarily need to be treated. Some women learn ways to prepare as well as possible for “heavier” days. But it’s a good idea to see a doctor and try to find out what the cause is.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 4, 2017

The introduction of the birth control pill in the 1960s was something of a revolution. Many hormonal contraceptives are available nowadays. More recent kinds include the contraceptive skin patch and the vaginal ring. Are they as reliable and well-tolerated as the "standard" contraceptives?

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 29, 2017

There are a number of forms of hormonal contraception, including the birth control pill, the vaginal ring, the contraceptive skin patch and hormone-releasing contraceptive coils. Although they are used in quite different ways, they have a similar effect: They all influence women’s hormone levels, and most of them prevent mature eggs from being released by the ovaries (ovulation). Hormonal contraceptives reliably prevent pregnancy, but they can have side effects such as headaches and breakthrough bleeding between periods – also known as “spotting.”In many countries, the birth control pill (sometimes simply called “the pill”) is the most commonly used form of contraception. Newer hormone-based methods like the skin patch and vaginal ring are less well known and not used as much. There are also hormone-based contraceptive coils. They are placed inside the womb, where they continuously release hormones.When used properly, hormonal contraceptives are a very reliable way to prevent pregnancy. But they don’t offer any protection against sexually transmitted diseases such as AIDS or hepatitis C. And they all have to be prescribed by a doctor. In Germany, the costs are covered by statutory health insurers in women under the age of 20.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 29, 2017

Oestrogen is widely used to suppress ovulation, mainly as a contraceptive. This is the first systematic review aiming to evaluate the effectiveness and safety of non‐contraceptive oestrogen‐containing preparations (oral, patch, implant and gel) in controlling symptoms of premenstrual syndrome (PMS).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 3, 2017

We investigated if giving drugs before surgery for uterine fibroids improves outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

This review of 23 trials involving 3043 women with endometriosis has shown that there no evidence of benefit with the use of ovulation suppression for women with endometriosis and infertility. Endometriosis is caused by the lining of the uterus (endometrium) spreading to a site outside the uterus. It is associated with subfertility and can cause pain during both sexual intercourse and menstruation. The hormone oestrogen stimulates the growth of endometriosis. For many years, the use of drugs such as danazol to stop ovulation and the production of oestrogen has been standard practice in the treatment of pain and subfertility caused by endometriosis. This works well for pain, but does not appear to improve fertility. In fact, as ovulation and periods are stopped for the time of treatment, fertility may be reduced by this approach.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

There is no proof that taking hormone medication before or after endometriosis surgery improves the outcome of the treatment. But hormone products such as GnRH analogues often have side effects and reduce fertility during treatment.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 19, 2017

Advanced (or metastatic) breast cancer is cancer that has spread beyond the breast and regional lymph node areas. Breast cancer can progress to metastatic disease despite the person undergoing a range of therapies given after initial treatment, such as surgery, chemotherapy or radiation therapy. Metastatic breast cancer is treatable but it is not curable. Most breast cancer is sensitive to the female hormone oestrogen. Sensitive cancer cells need oestrogen to stay alive and removal of oestrogen from the body, or stopping any circulating oestrogen getting to the cancer cells, is very effective treatment for hormone‐sensitive breast cancers. Endocrine (hormonal) therapy removes the influence of oestrogen on breast cancer cells. Hormonal treatments for advanced breast cancer include tamoxifen, the progestins megestrol acetate and medroxyprogesterone acetate, and aromatase inhibitors (AIs). AIs reduce the body's ability to make (synthesise) oestrogen and have tumour‐regressing effects. The AIs in current clinical use include anastrozole, exemestane, and letrozole.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Expert-reviewed information summary about pruritus (itching of the skin) as a complication of cancer or its treatment. Approaches to the management and treatment of pruritus are discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 15, 2016

Concerns about safety have led to making birth control pills with less of the hormone estrogen. Pills with less estrogen might not work as well to prevent pregnancy and could cause bleeding problems. This review looked at studies that compared pills with 20 µg ethinyl estradiol versus pills that have more estrogen.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Acne is a common skin problem for women. Several treatments are available. Combined birth control pills, which have the hormones estrogen and progestin, are often prescribed for women with acne. This review looked at how well birth control pills worked to treat facial acne.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Whether women with sickle cell anemia should use hormonal birth control is unknown. Sickle cell anemia is a blood disease. This type of anemia also causes bone pain known as sickle pain crises. A concern is that women with this disease using hormonal birth control may have blood vessels blocked by blood clots or have more bone pain. Clinicians often do not prescribe these types of birth control due to these concerns. However, many women with sickle cell anemia are sexually active, are able to get pregnant and are interested in contraception.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Premenstrual syndrome (PMS) is a common problem. A severe form is called premenstrual dysphoric disorder (PMDD). Birth control pills with the hormones progestin and estrogen have been studied for treating such symptoms. A birth control pill with the progestin drospirenone may work better than other such pills. A drospirenone pill with low estrogen was approved for treating PMDD, the severe form of PMS, in women who use birth control pills.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Side effects of birth control pills may keep women from using them as planned. Attempts to decrease side effects led to the three‐phase pill in the 1980s. Pills with phases provide different amounts of hormones over three weeks. Whether three‐phase pills lead to fewer pregnancies than two‐phase pills is unknown. Nor is it known if the pills give better cycle control or have fewer side effects. This review looked at whether two‐phase pills worked as well as three‐phase pills. We also studied whether women had fewer side effects with these pills.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Atypical endometrial hyperplasia commonly develops into endometrial carcinoma, which is the most common gynaecologic cancer in the world. The levonorgestrel‐releasing intrauterine system (LNG‐IUS) is thought to reduce the risk of endometrial hyperplasia. However, this review of the evidence found no randomised controlled studies (RCTs) of the efficacy and safety of the LNG‐IUS for treating women with a diagnosis of atypical endometrial hyperplasia. RCTS are required in this area.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Health care providers often tell women to wait until their next menstrual cycle to begin birth control pills. The main reason is to avoid using birth control during an undetected pregnancy. Another method involves starting the pills right away ('immediate start' or 'quick start'). Another birth control method should be used as back‐up for the first seven days. Unclear issues were whether quick start of hormonal birth control works as well as the usual start and whether women like it. The quick start method might improve women's use of hormonal birth control.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

The skin patch and the vaginal (birth canal) ring are two methods of birth control. Both methods contain the hormones estrogen and progestin. The patch is a small, thin, adhesive square that is applied to the skin. The contraceptive vaginal ring is a flexible, lightweight device that is inserted into the vagina. Both methods release drugs like those in birth control pills. These methods could be used more consistently than pills because they do not require a daily dose. This review looked at how well the methods worked to prevent pregnancy, if they caused bleeding problems, if women used them as prescribed, and how safe they were.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Using birth control pills as a form of contraception can improve the complexion of girls and women who have acne. Certain types of pills might be somewhat more effective in treating acne than others. But the differences are small.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 30, 2013

Cochrane authors compared the initiation rate, effectiveness, and side effects of insertion of a contraceptive implant (implant for birth control) soon after childbirth versus delayed insertion at postpartum visit.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 22, 2017

For most women, birth control pills, vaginal rings and contraceptive skin patches are very unlikely to affect their weight much. Many women slowly gain weight over the years, whether or not they use hormonal contraception.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 29, 2017

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