Use of hormonal contraceptives to suppress menstruation for medical or social indications

IUD: intrauterine device; DMPA: depot medroxyprogesterone acetate; GnRH: gonadotropin-releasing hormone.
* Choice of agent for menstrual suppression is determined by the patient. Typical factors include degree of menstrual suppression, frequency of dosing, route of dosing, adverse effects, need for contraception, and cost.
¶ Continuous dosing of the transdermal contraceptive patch is avoided because of theoretical concerns for increased risk of thromboembolic events.
Δ While the 52 mg levonorgestrel-releasing IUDs are associated with 1 year amenorrhea rates of 20%, the likelihood of amenorrhea for a specific patient is unpredictable.
◊ GnRH analogues rapidly achieve amenorrhea but are associated with adverse effects, including hot flashes, sleep disturbance, mood changes, and loss of bone density.