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Patients with heavy menstrual bleeding are offered a choice of non-hormonal and hormonal pharmacological treatment options.
A variety of pharmacological treatment options are available for people with heavy menstrual bleeding. These can be grouped into hormonal and non-hormonal treatments, with each category having special considerations for patients. Patients should be aware of the potential out-of-pocket costs of these options, since many drugs for heavy menstrual bleeding are not publicly funded or covered under private insurance plans.
Your health care professional should discuss with you options for hormonal and non-hormonal medication.
Ensure you provide patients with information on all available pharmacological options. Make patients aware of the potential out-of-pocket costs, since many of these treatments are not publicly funded or covered under private insurance plans. Inform patients that if they do not see results in 3 to 6 months they should come back for a follow-up appointment to reassess their treatment plan.
Ensure systems, processes, and resources are in place such that patients have access to their pharmacological treatment of choice.
Percentage of patients with heavy menstrual bleeding whose medical records indicate they were offered a choice of pharmacological treatments (hormonal and non-hormonal options)
Denominator: number of patients with heavy menstrual bleeding
Numerator: number of patients with heavy menstrual bleeding whose medical records indicate they were offered a choice of pharmacological treatments (hormonal and non-hormonal options)
Data source: local data collection
The following non-hormonal options can be used to treat heavy menstrual bleeding:
Tranexamic acid
Non-steroidal anti-inflammatory drugs (NSAIDs)
Note: NSAIDs also help relieve symptoms of dysmenorrhea.
The following hormonal options can be used to treat heavy menstrual bleeding:
Levonorgestrel-releasing intrauterine system
Combined hormonal contraceptives
High-dose continuous progestins
Patients with fibroids associated with heavy menstrual bleeding can try any of the above medications as well as the following two additional options that may be effective in shrinking fibroids and reducing associated bleeding symptoms
Gonadotropin-releasing hormone analogues
Selective progesterone-receptor modulators
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