The effects of mefenamic acid and norethisterone on measured menstrual blood loss

Article Abstract:

Menorrhagia, heavy menstrual blood flow, can be treated surgically by removing the uterus (hysterectomy). However, hysterectomy, the most common operation in reproductive-aged women, is not without risk. Menorrhagia can also be treated with birth control pills and drugs that promote clotting and inhibit prostaglandins, hormone-like substances involved in many physiological processes, including menstrual bleeding. The effects of two of the most common medical treatments for menorrhagia, the prostaglandin inhibitor mefenamic acid and norethisterone, a synthetic progesterone (hormone found in birth control pills), were studied. Menorrhagia, defined as a blood loss of greater than 80 milliliters per menstrual cycle, was diagnosed in 32 out of 72 women (44 percent) complaining of a heavy menstrual period. All 32 women ovulated during each cycle. Seventeen women received mefenamic acid (500 milligrams three times a day during their period) and 15 women received norethisterone (five milligrams twice a day on days 19-26 of the menstrual cycle). The women received the medication for a total of two cycles. The average blood loss decreased from 123 milliners to 81 milliliters after treatment with mefenamic acid and from 109 to 92 milliliters after treatment with norethisterone. The only difference between the two treatment groups was the number of days bleeding lasted (bleeding was reduced from seven days to five days in the mefenamic-treated group). Mefenamic acid and norethisterone were both effective in reducing the blood loss in women with proven menorrhagia. Minor side effects such as headache, nausea, and abdominal pain were experienced by 60 to 70 percent of the women in both treatment groups. Half the women who took mefenamic acid continued to have menorrhagia after two months of treatment, compared with 67 percent of the women receiving norethisterone. Overall the drugs reduced bleeding similarly and were well-tolerated, with only one woman from each group discontinuing therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mefenamic acid

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The effect of doxycycline on serum levels of ethinyl estradiol, norethindrone, and endogenous progesterone

Article Abstract:

Oral contraceptives (OC) represent one of the most effective methods of birth control. However, unplanned pregnancies have been reported in women using OCs who were being treated with several types of antibiotics. A clinical study was designed to determine the effect of an antibiotic, doxycycline (a tetracycline-like drug), on blood (serum) levels of the OC hormones, ethinyl estradiol and norethindrone, and a hormone produced naturally by the body, progesterone. For the control phase of the study, blood samples were drawn from 24 women (age range 18 to 35 years) who had been taking OC for at least two months; the purpose was to establish the normal or baseline levels of hormones during the end of their menstrual cycles (days 18, 19, and 20). During the treatment phase, the same women were given two daily doses of doxycycline for seven days beginning on day 14, and blood samples were again collected on days 18, 19, and 20. The blood levels of the three hormones were not different during the treatment phase versus the control phase. Moreover, there was no increase in the amount of progesterone, a sign of ovulation, during either phase of the study, which suggests that the antibiotic did not reduce the effectiveness of the OC by allowing ovulation to occur. The authors point out that a longer or earlier (in the cycle) testing period might provide different information about the effect of antibiotics on hormone levels. It is concluded that pregnancies attributed to the interaction of tetracycline and OCs could have actually occurred either because of the true failure rate of the OC (OCs are not 100 percent effective) or because of a real risk of interaction between the OCs and antibiotics that only affects a small number of women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Antibiotics, Complications and side effects, Physiological aspects, Oral contraceptives, Drug interactions, Progesterone, Doxycycline, Ethinyl estradiol

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A review of 35 endometrial ablations using the Nd:YAG laser for recurrent menometrorrhagia

Article Abstract:

A large proportion of hysterectomies are performed because women develop severe uterine bleeding (menometrorrhagia) that cannot be controlled with hormonal treatment or the removal of benign growths. One approach to treating this problem is the Nd:YAG (Neodymium-Yttrium-Argon-Garnet) laser, which partially or completely destroys the endometrium (uterine lining) in a process called endometrial ablation. The Nd:YAG laser was used to treat 35 patients who had recurrent menometrorrhagia for at least one year. The studies were conducted in 1987 and 1988. Series I patients (23) underwent treatment with danazol, a drug that reduces endometrial thickness, for 30 days before laser surgery. Series II patients (12) were treated with leuprolide acetate, which also causes endometrial thinning. Laser therapy was administered on an outpatient basis under general anesthesia; patients were told they would probably be sterile afterwards. Following ablation, 15 patients in series I and 6 in series II stopped menstruating completely. Seven women from series I resumed menstruation at an acceptable level; the eighth ultimately required a hysterectomy, as did one series II patient. The remaining series II patients had satisfactory outcomes. Overall, treatment with the Nd:YAG laser produced satisfactory results for more than 90 percent of the women with menometrorrhagia, and allowed most of them to avoid hysterectomy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Surgery, Lasers in surgery, Laser surgery

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