After the underlying cause of a menstrual disorder is uncovered, the physician can determine the best form of treatment. With the proper treatment, physicians may be able to establish or restore normal menstrual periods and possibly fertility.

Treatment decisions are based on a number of factors, including:

• Cause and extent of the disorder
• Predicted progression of the disorder
• Effect of the disorder on the patient’s daily life
• The patient’s age and overall health
• The patient’s medical history
• The patient’s tolerance for certain medications, procedures and therapies
• The patient’s personal preferences
• Fertility

Common treatments include:

• Oral contraceptives. Birth control pills may be used to treat menstrual disorders. There is a wide variety of types and forms available, and these medications are commonly used to treat polycystic ovarian syndrome and endometriosis, and to regulate irregular menstrual cycles.
  
  
• Hormone replacement therapy. Hormonal medications containing estrogen, and in some cases progesterone, may be recommended for the symptoms of menopause.
  
  
• Lifestyle changes. A physician may recommend changes in diet and exercise regimen.
  
  
• Analgesics (e.g., ibuprofen). Painkillers may be used to relieve pelvic pain and discomfort associated with menstrual disorders. Additionally, ibuprofen has been shown to decrease menstrual bleeding in some studies.

In some cases medication can trigger a menstrual disorder. Physicians may recommend that patients with medication-induced menstrual disorders switch to another medication.

Lifestyle changes and medications are usually the first line of treatment for menstrual disorders. However, these methods are not always successful and surgery may be recommended.

Surgeries that may be used to treat certain menstrual disorders include:

• Dilation and curettage (D&C). During D&C, the uterus is widened (dilated). The physician then removes the tissue by suction or sharp curettage (scraping). In some cases, a long metal instrument with a loop on the end (curette) will be used to scrape the walls of the uterus after suctioning, a process known as curettage. This procedure may be used to remove abnormal growths (e.g., polyps, fibroids) or cancer.
  
  
• Endometrial ablation (EMA). During EMA, the physician uses a hysteroscope (a thin, lighted, flexible tube) to view the uterine lining. Then one of several different methods (e.g., laser, electrocautery instrument, thermal balloon) is used to remove or destroy the uterine lining. Pregnancy is not possible after EMA.
  
  
• Endometrial resection (EMR). A surgical procedure involving the removal of the endometrial lining (the lining of the uterus) with an electrosurgical wire loop. In addition to removing the uterine lining, a quarter-inch of the uterus’ underlying muscle is removed. Resection can be used in women who have heavy bleeding but do not have any other underlying uterine problems. Pregnancy is not possible after an EMR.
  
  
• Hysterectomy. In some severe circumstances the surgical removal of a woman’s uterus may be necessary.

In some cases, the diagnosis of an underlying condition such as cancer or early menopause can result in extreme distress. As a result, psychological counseling is sometimes a component of treatment.