Ah, that time of the month. It’s every girl, and woman’s, truest joy. So much so that she lovingly adopted the name ‘aunt flow’. But what happens when aunt flow hangs around too often (or never) or is much, much crankier than she should be? Why, turn to your OB/GYN, of course! As always, we’ve got a few tricks up our lab coat sleeves to help you kick her out of your house, give her the happy pill, or both. Now, let’s talk about these so-called ‘tricks’ and what they might entail.
Typical first line for heavy, annoying periods? Birth control! Yep, birth control is the best, easiest, and often first approach to tackling any angry uterus issues. Below are some of the forms of birth control we may use, why, and the pros and cons. Keep in mind that every body is different—what’s right for you may not be right for your bff, sister, or cousin. Getting birth control exactly right can also take some time, effort, and patience. But the reward can be awesome.
- Pills: taken daily, pills can help make periods lighter, regular, and less crampy. Pros:noninvasive, predictable periods Cons: taking a pill every day
- Hormonal IUD: around 80% of women with the Mirena IUD stop having periods all together. It’s truly a miracle. Pros: one-time insertion for 5 years of effectiveness, no period or few periods Cons: crampy insertion
But what if you’re trying to get pregnant? Good question! Clearly birth control wouldn’t be a great fit for you if you’re trying to conceive. So we turn to a progesterone regimen to help regulate your periods without decreasing your chances at getting pregnant. This regimen, provera, uses the hormone progesterone to help regulate your cycles each month. Your provider will give you detailed instructions regarding how to take the medication each month (so the following is a loose explanation!). Typically, you will take this medication for a set number of days at a designated time of the month. After finishing the preset amount of pills, you will then (we hope) have a regular period within the few days following. This can be done for months at a time or more without interfering with your fertility. It may, in fact, help with fertility if you do not menstruate monthly. Bottom line: this medication can be helpful for women experiencing any form of irregular bleeding (too much or too little) who don’t need or want any birth control.
And finally, what if you’re done having children but haven’t hit menopause yet? The Mirena IUD is one of the first line therapies for those experiencing heavy, painful periods. If the IUD is not an option, or has not helped, surgical intervention is usually needed. Depending on your own goals and preferences, as well as your health, your provider may suggest either an ablation or a hysterectomy. An ablation is a procedure that cauterizes (burns) the lining of your uterus, destroying the tissue and preventing bleeding. A hysterectomy is the removal of your uterus. As providers, we like to save surgical interventions for last.
Written by contributing author, Kara Earthman, Women's Health CRNP, and founder the of Kara Earthwoman blog.