Treatment involves hormones -- both estrogens and progestins, as well as prescribed iron supplements.
The first treatment is high doses of estrogen. Depending on the amount of blood loss you are experiencing, as well as the results of other tests, your doctor may begin treatment through an IV, or prescribe estrogen pills.
Estrogens usually control severe acute bleeding quickly. However, when estrogens fail to control it, dilation and curettage, or a D & C, is sometimes necessary.
Once severe acute bleeding is under control, by either estrogen treatment or D & C, the usual treatment continues with oral contraceptives prescribed on a tapering dose schedule. This may mean that your doctor tells you, for example, to take four pills the first day, followed by three pills the second next day, two pills, the third day, and one pill on the fourth day. Your doctor may prescribe a different tapering dose schedule for you. It’s important that you follow your doctor’s instructions exactly as prescribed.
After treatment controls your vaginal bleeding, your doctor can determine the cause.
Source: John W. Ely, MD, MSPH, Colleen M Kennedy, MD, MS, Elizabeth C. Clark, MD, MPH, and Noelle C. Bowdler, MD; “Abnormal Uterine Bleeding: A Management Algorithm;” JABFM November – December 2006, Vol. 19 No. 6; http://www.jabfm.org/cgi/content/full/19/6/590; accessed 12/09/07.
