Hypermenorrhea: Drug Therapy

Therapeutic target

Improvement of symptoms by drug control of bleeding disorders (hypermenorrhea, menometrorrhagia) or preoperative reduction of fibroids (benign growths in the muscular layer of the uterus).

Therapy recommendations

  • Estrogen-progestin monophasic preparations, progestin preparations, intrauterine device (“IUD”) with progestin (levonorgestrel) for drug control of bleeding disorders.
  • Ulipristal (ulipristal acetate* ; progesterone receptor modulator) for preoperative (“before surgery”) reduction of fibroids Note: There are four case reports of severe liver injury during therapy with ulipristal, three of which required liver transplants.
  • See also under “Other Therapy.”

* Note: The EMA Safety Committee is reviewing ulipristal acetate-containing agents used for therapy in uterine fibroids. It recommends discontinuing use of 5 mg ulipristal acetate for treatment in uterine fibroids for the period of the current risk assessment (March 23, 2020).