Effectiveness and mechanism of action of desmopressin in the treatment of copper intrauterine device-related menorrhagia: a pilot study

Mercorio, Francesco

doi:10.1093/humrep/deg449

Cited by 24 publications

(9 citation statements)

References 17 publications

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“…However, intranasal DDAVP had no effect on menstrual fluid fibrinolytic activity in a small study of women with menorrhagia [60]. Intranasal DDAVP is generally well tolerated, but adverse effects have occurred in 25-70% of patients in different studies [54,57,58]. In two small, randomized studies, adverse effects were not significantly more frequent with DDAVP than placebo [57,59].…”

Section: Desmopressinmentioning

confidence: 97%

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von Willebrand's disease and menorrhagia: Prevalence, diagnosis, and management

Kujovich¹

2005

American J Hematol

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The reported prevalence of von Willebrand's disease (vWD) is increased in women with menorrhagia, with current estimates ranging from 5% to 20%. The consistent results of multiple studies suggest testing should be included in the evaluation of patients with menorrhagia, especially in unexplained cases and prior to surgical intervention. Although a cyclic variation in von Willebrand's factor levels has not been confirmed, several studies suggest lower levels during menses and the early follicular phase. Menorrhagia is one of the most common bleeding manifestations of von Willebrand's disease, reported by 60-95% of women afflicted with this bleeding disorder. Menorrhagia is typically severe, often resulting in anemia and interfering with quality of life. Despite the frequency of menorrhagia, there is no consensus on optimal management. Although oral contraceptives are frequently prescribed, there are no studies confirming their efficacy using objective measures of response. Desmopressin was associated with an 80-92% response rate in several uncontrolled studies relying on patient assessment of efficacy. However, a small, randomized trial found no significant reduction in menstrual blood flow compared with placebo. There are anecdotal reports of the successful use of antifibrinolytic agents alone and in combination with other therapies. There are no studies comparing the relative efficacy and safety of the available medical therapies for von Willebrand's disease associated menorrhagia. Until these studies are completed, treatment should be individualized based on von Willebrand's disease subtype, patient age, contraceptive needs, and personal preference. Am.

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Section: Desmopressinmentioning

confidence: 97%

“…Mean pictorial blood assessment chart scores were significantly lower than pretreatment baseline scores after both DDAVP and placebo, illustrating the importance of the placebo effect in this setting. DDAVP has also been shown to reduce menstrual blood loss in women with menorrhagia due to other causes [58,59].…”

Section: Desmopressinmentioning

confidence: 99%

von Willebrand's disease and menorrhagia: Prevalence, diagnosis, and management

Kujovich¹

2005

American J Hematol

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“…Nine studies examined the use of various oral NSAIDs for the treatment of heavy or prolonged menstrual bleeding among Cu-IUD users and compared them with either a placebo or a baseline cycle. Three of these trials examined the use of indomethacin (127)(128)(129), three examined mefenamic acid (130)(131)(132), and three examined flufenamic acid (127,128,133). Other NSAIDs used in the reported trials included alclofenac (127,128), suprofen (134), and diclofenac sodium (135).…”

Section: Bleeding Irregularities With Cu-iud Usementioning

confidence: 99%

U.S. Selected Practice Recommendations for Contraceptive Use, 2016

Curtis

Jatlaoui²,

Tepper³

et al. 2016

MMWR Recomm. Rep.

342

351

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The 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses a select group of common, yet sometimes controversial or complex, issues regarding initiation and use of specific contraceptive methods. These recommendations for health care providers were updated by CDC after review of the scientific evidence and consultation with national experts who met in Atlanta, Georgia, during August 26-28, 2015. The information in this report updates the 2013 U.S. SPR (CDC. U.S. selected practice recommendations for contraceptive use, 2013. MMWR 2013;62[No. RR-5]). Major updates include 1) revised recommendations for starting regular contraception after the use of emergency contraceptive pills and 2) new recommendations for the use of medications to ease insertion of intrauterine devices. The recommendations in this report are intended to serve as a source of clinical guidance for health care providers and provide evidence-based guidance to reduce medical barriers to contraception access and use. Health care providers should always consider the individual clinical circumstances of each person seeking family planning services. This report is not intended to be a substitute for professional medical advice for individual patients. Persons should seek advice from their health care providers when considering family planning options.

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“…1 , 19 Limited evidence exists regarding use of intranasal desmopressin to decrease mean blood loss. 1 , 20 …”

Section: Copper-intrauterine Devicementioning

confidence: 99%

Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates

Villavicencio¹,

Allen²

2016

OAJC

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Approximately half (51%) of the 6.6 million pregnancies in the US each year are unintended and half of those pregnancies (54%) occur among women not using contraception. Many women discontinue their contraceptives due to method dissatisfaction. Bothersome unscheduled bleeding is one of the main reasons cited by women for stopping a birth control method. Improving counseling and management of these side effects will aide in increasing satisfaction with contraceptive methods. The following review will discuss the bleeding profiles associated with the contraceptive options available in the US. A valuable resource from the Centers for Disease Control and Prevention, the US Selected Practice Recommendations for Contraceptive Use, will be introduced. Definitions of the types of unscheduled bleeding are included, as well as strategies for treatment for each contraceptive method. The evidence whether or not anticipatory counseling increases continuation rates will also be reviewed.

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Effectiveness and mechanism of action of desmopressin in the treatment of copper intrauterine device-related menorrhagia: a pilot study

Abstract: Desmopressin may be a useful therapeutic tool for many women with IUD-related menorrhagia. Its mechanism of action lies in an ability to enhance local haemostasis, without affecting uterine blood flow.

Cited by 24 publications

References 17 publications

von Willebrand's disease and menorrhagia: Prevalence, diagnosis, and management

von Willebrand's disease and menorrhagia: Prevalence, diagnosis, and management

U.S. Selected Practice Recommendations for Contraceptive Use, 2016

Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates

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