[Medical treatment of idiopathic menorrhagia]

Heavy menstrual bleeding is frequent, and can be caused by particular uterine abnormalities such as fibroids or adenomyosis but there is often no recognisable pathology. Surgery such as hysterectomy has proven its efficacy in treating these conditions, but alternatives techniques have been developed since many years and give interesting results. New medical treatments have also emerged, and in particular a new intrauterine levonorgestrel-releasing system (IUD-LNG). In case of dysfunctional uterine bleeding, the use of medical treatment should be considered in first line. Progestogens are often used in this condition even if it has been proven that they are less effective than antifibrinolytics, non steroid anti-inflammatory drugs or IUD-LNG. Appropriate treatment should be considered according to clinical conditions and based on efficacy, tolerance, cost and should also take into account the patient's wishes as observance in case of medical therapy is of particular importance. In case of DUB, medical therapy when correctly prescribed is effective.