A comparison of flurbiprofen, tranexamic acid, and a levonorgestrel-releasing intrauterine contraceptive device in the treatment of idiopathic menorrhagia

Article Abstract:

Menorrhagia, excessive menstrual blood loss, occurs in 10 percent of healthy women and can cause iron-deficiency anemia. Hysterectomy is the last resort treatment in idiopathic (no known cause) menorrhagia. Approximately 18,000 such operations are performed in England and almost 500,000 are done in the US each year. As surgery carries a certain amount of risk for illness or death, it is advisable to try medical treatment first. Antifibrinolytic agents, which can enhance the process of clotting; prostaglandin synthetase inhibitors, which block formation of prostaglandins (locally-acting hormones which mediate many important cellular responses); and progestogens (progesterone-like compounds) have all been effective in treating menorrhagia. To compare the effectiveness of such therapies, the results of treatment with flurbiprofen (a prostaglandin synthetase inhibitor), tranexamic acid (an antifibrinolytic agent), or an intrauterine contraceptive device (IUD) releasing levonorgestrel (a progestogen) were evaluated in 35 women with menorrhagia. Sixteen of 20 women fitted with the IUD completed the study, and blood loss dropped substantially, to normal levels. Blood loss also decreased significantly in women treated with either flurbiprofen or tranexamic acid, but not to normal levels. Blood loss reduction was greater with the IUD than with the oral medications, and greater with tranexamic acid compared with flurbiprofen. Seven of 15 and 4 of 15 women treated with tranexamic acid or flurbiprofen, respectively, experienced side effects. The results suggest that levonorgestrel-releasing IUDs are a valid alternative to hysterectomy in the treatment of menorrhagia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Dosage and administration, Intrauterine devices, Carboxylic acids, Progestational hormones, Synthetic, Progestational agents, Contraceptive drugs, Levonorgestrel, Intrauterine contraceptives, Medicated, Flurbiprofen

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Gestrinone in the treatment of menorrhagia

Article Abstract:

Menorrhagia, excessive menstrual blood loss (MBL), is a significant and common medical problem. Hysterectomy (removal of the uterus) is a common treatment for menorrhagia, but hormone-like drugs are increasingly being tried as alternatives to surgery. Gestrinone blocks the effects of the female sex hormones progesterone and estrogen, and has some male sex hormone activity. It has been reported to decrease MBL or cause amenorrhea in menorrhagic patients, but blood loss was not measured precisely in previous studies. The effect of gestrinone on menorrhagia in 19 women was determined with objective measurements of MBL. MBL was significantly reduced in 15 of 19 patients treated with gestrinone for 12 weeks. Initially, gestrinone increased MBL in the first month, but patients then developed lower MBL or even amenorrhea (absence of menstruation). Side effects included spotting, in all patients, and there was an average weight gain of five pounds. By the third period after gestrinone treatments were stopped, MBL had returned to pre-treatment levels. Nine patients subsequently had hysterectomies, four of whom had not responded to therapy. Uterine tumors were found in three of these four patients. The study suggests that gestrinone may effectively treat menorrhea and can provide an alternative to hysterectomy to women who can accept a side effect of amenorrhea. (Consumer Summary produced by Reliance Medical Information, Inc.)

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