Options for menstrual suppression

Choice of method for menstrual suppression depends on:

• whether reduction in flow or complete avoidance of menses is desired
• whether contraception is needed
• other individual factors (eg comorbidities, vulnerability to osteoporosis and its sequelae).

Levonorgestrel-releasing intrauterine contraceptive devices significantly reduce menstrual loss and dysmenorrhoea.

Progestogen-only contraceptive pills or combined hormonal contraceptives result in predictable periods that are usually lighter and less painful. Many females seek continuous daily treatment (to achieve no periods) for up to 12 months or longer before ceasing for 4 to 7 days to menstruate. See Tailored regimens of combined hormonal contraception. Postponing menstruation for social reasons is discussed here. For potential interactions of combined oral contraceptives with antiepileptic drugs, see Contraception in patients with epilepsy.

Depot medroxyprogesterone contraception (see Injectable hormonal contraception) is a long-acting option for menstrual suppression in females who are unable to tolerate oral medications, but can tolerate an injection. Advantages and disadvantages of depot medroxyprogesterone contraception are listed in Advantages and disadvantages of depot medroxyprogesterone contraception.

Strategies to facilitate medical procedures (ie injections, implant insertion) for people who find them difficult are discussed in Physical examination and investigations.