Many of our USC Fertility patients ask me if there are ways to decrease their menstrual flow. Here are some tips to help get you started:

1. Ibuprofen 
Ibuprofen is one of several medications classified as a non-steroidal anti-inflammatory drug (NSAID). These drugs work by reducing your body’s production of inflammatory elements called prostaglandins. Prostaglandins have important actions on the blood vessels in the inner lining of the uterus, thereby affecting the amount of bleeding that occurs during a menstrual period.

Using an NSAID at the time of a period can decrease the amount of bleeding by 20-40%, and sometimes by even more if a woman normally has very heavy periods. NSAIDs also work great for relieving menstrual cramps.

2. Birth Control Pills
Even if you do not need to take the pill for birth control, a great advantage of the pill is the reduction in heavy menstrual bleeding.

Birth control pills contain two hormones–estrogen and progesterone–that are similar to the hormones your body normally produces throughout the menstrual cycle. The progesterone part of the pill thins the inner lining of the uterus, which results in up to 40% less bleeding during the menstrual period. There is also the option to take “continuous” birth control pills, which can reduce the frequency of your periods to once every 3 months or even once a year!

3. Intra-Uterine Device (IUD)
An IUD is a T-shaped device that your doctor can place inside the uterus to prevent pregnancy. Mirena is an IUD that contains a progesterone-like hormone that is released slowly over 5-10 years. Similar to the birth control pill, the progesterone from the IUD thins the uterine lining. In women with heavy periods, this method can reduce the amount of bleeding by 75-95%.

4. Cyclic Progesterone Pills
You may have noticed a common theme in the methods discussed above: progesterone-like hormones are successful in reducing menstrual flow. It is possible to take pills containing only progesterone, and these are usually prescribed in the latter part of your menstrual cycle about 10-14 days before you expect to get a period.

This method is generally not the best choice because it is about as effective as taking NSAIDs but has more side effects (bloating, feeling tired) and is not as effective as birth control pills or the Mirena IUD.