Treatment of Heavy and/or Prolonged Menstrual Bleeding Without Organic Cause

Inclusion Criteria: Regular menstrual cycles with BMI (19-29 kg/m2). Heavy and/or prolonged menstrual bleeding involving at least last three consecutive menstrual cycles. Exclusion Criteria: 1. Postmenopausal bleeding (over one year since the last menstrual period). 2. Irregular menses or intermenstrual bleeding. 3. Organic causes of heavy menstrual bleeding suspected or confirmed by experienced abdominal and transvaginal ultrasound after thorough general and gynecological examination. 4. Iatrogenic (treatment-related) causes of heavy menstrual bleeding (e.g. non-progestogen-releasing intrauterine contraceptive device, oral contraceptives, other hormonal drug use or anticoagulant agent). 5. Iron deficiency anemia. 6. History of chronic diseases known to interfere with menstrual bleeding or prevent the use of any of the listed drugs e.g previous or current thromboembolic disease.