What medications can stop a menstrual period?

Medications That Can Stop Menstrual Periods

Several hormonal contraceptives can effectively stop menstrual periods, with depot medroxyprogesterone acetate (DMPA) injections and continuous use of combined hormonal contraceptives being the most reliable options. 1, 2

First-Line Options

Depot Medroxyprogesterone Acetate (DMPA)

• DMPA injections (150 mg intramuscularly or 104 mg subcutaneously) are highly effective at stopping menstrual periods, with approximately 50-60% of women experiencing amenorrhea within 1 year of use 1
• Injections are administered every 12 weeks and are reversible 1
• Amenorrhea rates increase with duration of use, making this an excellent option for long-term menstrual suppression 1

Combined Hormonal Contraceptives (Extended or Continuous Use)

• Combined oral contraceptives (COCs), patches, or vaginal rings can be used continuously by skipping the hormone-free interval 2
• To achieve amenorrhea, users should take only the active hormonal pills continuously and skip the placebo pills 2, 3
• Extended-cycle oral contraceptives are specifically designed for fewer periods:
  • 84/7 regimens (84 days of active pills followed by 7 days of placebo or low-dose estrogen) reduce periods to 4 times per year 4
  • Continuous regimens (365 days of active pills with no placebo) can eliminate periods entirely 4

Second-Line Options

Hormonal IUDs

• Levonorgestrel-releasing intrauterine systems (LNG-IUS) can significantly reduce menstrual bleeding and may lead to amenorrhea in 20-50% of users after one year 2
• Provides long-acting contraception (3-7 years depending on the specific product) 5

Contraceptive Implants

• Subdermal etonogestrel implants can cause amenorrhea in approximately 22% of users 1
• Provides long-acting contraception for up to 3 years 5

Managing Breakthrough Bleeding

If breakthrough bleeding occurs while attempting to stop periods:

• Short-term use of NSAIDs (5-7 days) may help reduce breakthrough bleeding 1
• For implant users experiencing problematic bleeding, studies show that oral celecoxib (200 mg daily for 5 days) or mefenamic acid (500 mg three times daily for 5 days) can significantly reduce bleeding 1
• For continuous COC users with breakthrough bleeding, a 3-4 day hormone-free interval may improve subsequent bleeding patterns 2

Important Considerations

• Amenorrhea during hormonal contraceptive use is generally not harmful and does not require medical treatment 1, 2
• Before starting any method to stop periods, pregnancy should be ruled out 3
• Breakthrough bleeding is common, especially during the first few months of use 1
• If amenorrhea persists and is unacceptable to the patient, alternative contraceptive methods should be discussed 1

Contraindications and Cautions

• Combined hormonal contraceptives increase the risk of venous thrombosis from 2-3 events per 10,000 women-years to 7-10 events per 10,000 women-years 5
• Progestin-only methods (DMPA, implants, hormonal IUDs) have fewer serious risks and are options for women with contraindications to estrogen 5
• DMPA may cause bone mineral density loss with long-term use, though this is generally reversible after discontinuation 1

Most Effective Approach for Menstrual Suppression

For patients specifically seeking to stop periods (rather than just contraception):

1. DMPA injections offer the highest rates of amenorrhea with continued use 1
2. Continuous use of combined hormonal contraceptives is also highly effective 2, 4
3. Hormonal IUDs provide a long-acting option with increasing amenorrhea rates over time 2