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Menorrhagia (heavy menstrual bleeding) - Management
What should I do if initial drug treatment is ineffective in a woman with menorrhagia?
- If initial treatment fails to produce an adequate reduction in menstrual bleeding (and treatment was complied with), consider three options:
- Switch to an alternative pharmaceutical treatment. Oral norethisterone or depot medroxyprogesterone are often suitable if initial treatment was ineffective.
- Add on an additional drug. Typically, tranexamic acid can be combined with a nonsteroidal anti-inflammatory drug (NSAID), or an NSAID can be combined with the combined oral contraceptive.
- Refer to a specialist.
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