Research Activities, May 2013

Combined oral contraceptives effective in treating abnormal uterine bleeding

Women's Health

A new research review from AHRQ finds that there is strong evidence for the use of combined oral contraceptives (COCs) to improve menstrual regularity and reduce menstrual blood loss for women with abnormal uterine bleeding (AUB). The review focuses on evaluation of nonsurgical options to treat AUB, with an emphasis on interventions that are accessible to and within the scope of usual practice for primary care practitioners in any clinical care setting. 

The review finds that effective treatment options (both contraceptive and noncontraceptive) are available in the primary care setting for women who have problematic, irregular, or heavy cyclic menstrual bleeding. In addition to COCs, Metformin®, a drug commonly used to treat diabetes, also improves cycle regularity. Other treatments, such as progestogens and non-steroidal anti-inflammatory drugs (NSAIDs) also have varying levels of effectiveness in women with irregular bleeding patterns.

While this review finds strong evidence of the effectiveness of COCs for the treatment of AUB, additional studies are needed that look at both biological and patient-reported outcomes over longer periods of time and in women who are representative of those seeking treatment by their primary care providers. Abnormal uterine bleeding is among the most common of gynecologic complaints from women of reproductive age in ambulatory care settings – of similar frequency to the number of women seeking care for urinary tract infections and vaginitis. In the general population, AUB is estimated to affect 11 to 13 percent of reproductive-age women. The prevalence increases with age, reaching 24 percent in women aged 36 to 40. 

You can access the research review, Primary Care Management of Abnormal Uterine Bleeding at:

Page last reviewed May 2013
Page originally created May 2013
Internet Citation: Combined oral contraceptives effective in treating abnormal uterine bleeding. Content last reviewed May 2013. Agency for Healthcare Research and Quality, Rockville, MD.