Abnormal Uterine Bleeding in Pre-Menopausal Women

Singh, Sukhbir S.; Best, Carolyn; Dunn, Sheila; Leyland, Nicholas; Wolfman, Wendy; Allaire, Catherine; Awadalla, Alaa; Heywood, Mark; Lemyre, Madeleine; Marcoux, Violaine; Menard, Chantal; Potestio, Frank; Rittenberg, David

doi:10.1016/s1701-2163(15)30939-7

Cited by 116 publications

(82 citation statements)

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“…AUB may be defined as any variation from the normal menstrual cycle, and includes changes in regularity and frequency of menses, in duration of flow, or in amount of blood loss. 6 In the majority of the cases no organic pathology is identified and DUB is considered as diagnosis of exclusion. DUB accounts for almost 50% of cases of excessive menstruation and is of two types ovulatory (20%) or anovulatorty (80%).…”

Section: Discussionmentioning

confidence: 99%

Ormeloxifene versus Tranexamic acid in dysfunctional uterine bleeding comparative evaluation

Hymavathi

Gottipati

Prasuna

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Dysfunctional Uterine bleeding (DUB) is the most common cause of abnormal uterine bleeding (AUB). Medical therapy being the first line of management, an ideal drug should be able to block the estrogenic effects on the Endometrium without interfering with its beneficial effects on other tissues. Both Ormeloxifene - a selective estrogen receptor modulator (SERM) and Tranexamic acid-an anti fibrinolytic inhibitor is important in the treatment of DUB. The aim of this study is to assess the efficacy and safety of Ormeloxifene v/s Tranexamic acid in the treatment of DUB.Methods: This is a prospective double blind study conducted for 2 years in 200 women presenting with DUB attending to the Gynaecology outpatient department (OPD) of Narayana Medical College and Hospital, Nellore, AP, India. Two hundred women presenting with DUB were recruited into this study (after fulfilling inclusion and exclusion criteria) with informed consent and randomly divided into two equal groups (Group-A and Group-B) after obtaining college ethical committee approval.Results: The reduction in the mean pictorial blood loss assessment chart (PBAC) score with Ormeloxifene (from 278 to 97.6) was significantly more than that of Tranexamic acid (from 261 to 134.5) at six months (p <0.0001). The rise in Hemoglobin concentration (8.4g% to 11.15g% vs. 8.5 to 9.7gm%; p <0.008) and reduction in Endometrial thickness (from 10.57mm to 6.5mm v/s 9.96mm to 7.24mm p <0.0001) were also significantly more with Ormeloxifene than with Tranexamic acid. Relief from dysmenorrhoea and subjective improvement were also found to be considerable with Ormeloxifene.Conclusions: Both Ormeloxifene and Tranexamic acid can be considered for DUB treatment but Ormeloxifene is found to be superior to Tranexamic acid in various aspects.

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Section: Discussionmentioning

confidence: 99%

Ormeloxifene versus Tranexamic acid in dysfunctional uterine bleeding comparative evaluation

Hymavathi

Gottipati

Prasuna

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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“…One of the most common reasons for female patients to seek health care is abnormal bleeding, which is irregular and more intense than previous periodic menstrual bleeding (1). About 20% of girls and women experience AUB disorder in their lifetime (2).…”

Section: Introductionmentioning

confidence: 99%

“…Even in 10% of cases of failure to respond to current treatments, the physician and patient are convinced to use hysterectomy, which may cause some physical and mental symptoms, such as depression and obesity (5). apy and combination of prostaglandin inhibitors nonsteroidal anti-inflammatory drugs, oral contraceptive, and gonadotropin agonists, but also they can use the whole range of complementary and alternative medicines (1,2).…”

Section: Introductionmentioning

confidence: 99%

Traditional Dry Cupping Therapy Versus Medroxyprogesterone Acetate in the Treatment of Idiopathic Menorrhagia: A Randomized Controlled Trial

Azizkhani

Dastjerdi

Arani

et al. 2018

Iran Red Crescent Med J

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Background: Dry cupping has been used as a treatment for abnormal uterine bleeding in Iranian traditional medicine. Objectives: The present study aimed at evaluating the usefulness of dry cupping on excessive menstrual blood loss in menorrhagia with a well-validated menstrual pictogram compared to medroxyprogesterone acetate. Methods: A total of 162 women with menorrhagia were enrolled in this prospective, randomized, controlled trial in Iran from 2015 to 2016. Written informed consent was obtained, then, patients were randomly allocated into dry cupping (3 sessions of interrupted and kinetic dry cupping during menstrual bleeding) or medroxyprogesterone acetate (10 mg/day throughout the luteal period) groups using a random number sequence. The number of bleeding days and objective estimation of menstrual blood loss using a pictorial blood loss assessment chart (PBAC) were recorded before the intervention and at specific intervals (1 and 3 months post intervention). Results: At 1 and 3 months, PBAC scores were significantly lower in women treated with cupping compared with women treated with medroxyprogesterone acetate. These reductions in PBAC score were 214.9 mL with 95% CI (120.5 to 309.2) greater than medroxyprogesterone acetate at 1 month and 237.3 with 95% CI (143.0 to 331.7) at 3-month follow-up period. Reduction in the number of bleeding days in the cupping group for almost one day was better than the control groups at 1 and 3 months follow-up (Mean difference:-1.03, 95% CI (-1.78 to -0.26), P = 0.007). Conclusions: Dry cupping is an effective treatment in reducing the intensity of bleeding during menstrual period compared to medroxyprogesterone acetate.

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“…Abnormal vaginal bleeding associated with anticoagulant use in women of reproductive age is frequently related to the menstrual cycle, and may involve prolonged, heavy or intermenstrual bleeding 11, 22. It decreases quality of life and may impact daily activities 22.…”

Section: Discussionmentioning

confidence: 99%

“…It decreases quality of life and may impact daily activities 22. Physicians should be aware of this complication and inform the patients at risk.…”

Section: Discussionmentioning

confidence: 99%

Abnormal vaginal bleeding in women of reproductive age treated with edoxaban or warfarin for venous thromboembolism: a post hoc analysis of the Hokusai‐VTE study

Scheres

Brekelmans

Ageno

et al. 2018

BJOG

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ObjectiveTo investigate the characteristics and outcome of abnormal vaginal bleeding in women receiving edoxaban or warfarin for treatment of venous thromboembolism (VTE).Design and settingPost hoc analysis of the Hokusai‐VTE study, a multicentre, randomised, double‐blind trial comparing edoxaban with warfarin for acute symptomatic VTE.PopulationWomen below 50 years receiving edoxaban or warfarin for treatment of VTE.MethodsWe collected data on diagnostic measures, treatment, and clinical outcome of abnormal vaginal bleeding events.Main outcome measuresOccurrence of major and clinically relevant nonmajor (CRNM) abnormal vaginal bleeding events.ResultsIn all, 628 women aged under 50 years were treated with edoxaban and 665 with warfarin. The rate of abnormal vaginal bleeding was 15/100 person‐years (py) (95% CI 11–19) in women receiving edoxaban and 9/100 py (95% CI 6–12) in the warfarin group (hazard ratio: 1.7, 95% CI 1.1–2.5). Major abnormal vaginal bleeding occurred in eight (1.3%) women on edoxaban and in three (0.9%) women receiving warfarin [odds ratio (OR) 2.8; 95% CI 0.8–10.8], and CRNM abnormal vaginal bleeding occurred in 53 (8.4%) women treated with edoxaban and in 37 (5.6%) on warfarin therapy (OR 1.6, 95% CI 1.0–2.4). Over 85% of all vaginal bleeds were characterised by heavy menstrual bleeding. Major bleeds frequently required treatment, and in more than 75% of patients anticoagulant therapy was adjusted. The severity of clinical presentation and course of major and CRNM bleeds was mild in most patients.ConclusionsAbnormal vaginal bleeding occurred more frequently in women treated with edoxaban than with warfarin. Reassuringly, most events could be managed conservatively and had a mild outcome.Tweetable abstractAbnormal vaginal bleeding occurred more frequently in women treated with edoxaban than with warfarin.

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Abnormal Uterine Bleeding in Pre-Menopausal Women

Cited by 116 publications

References 0 publications

Ormeloxifene versus Tranexamic acid in dysfunctional uterine bleeding comparative evaluation

Ormeloxifene versus Tranexamic acid in dysfunctional uterine bleeding comparative evaluation

Traditional Dry Cupping Therapy Versus Medroxyprogesterone Acetate in the Treatment of Idiopathic Menorrhagia: A Randomized Controlled Trial

Abnormal vaginal bleeding in women of reproductive age treated with edoxaban or warfarin for venous thromboembolism: a post hoc analysis of the Hokusai‐VTE study

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