Treatment of Menorrhagia with Tranexamic Acid. A Double-blind Trial

Callender, Shei La T.; Warner, G. T.; Cope, E. D.

doi:10.1136/bmj.4.5729.214

Cited by 113 publications

(51 citation statements)

References 7 publications

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“…Treatment with tranexamic acid was found to reduce MBL by 34-54% compared to a placebo in different studies [21,22,23]. Our results (60.8% decrease in blood loss) were slightly more successful and were similar to the results of a phase 3, open prospective trial by Gultekin et al [24], who reported a 65.9% success rate in 2009.…”

Section: Discussionsupporting

confidence: 80%

Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study

Kiseli

Kayıkçıoğlu

Evliyaoğlu

et al. 2016

Gynecol Obstet Invest

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Background: Our aim was to compare the therapeutic efficacies of norethisterone acid (NETA), tranexamic acid and levonorgestrel-releasing intrauterine system (LNG-IUS) in treating idiopathic heavy menstrual bleeding (HMB). Methods: Women with heavy uterine bleeding were randomized to receive NETA, tranexamic acid or LNG-IUS for 6 months. The primary outcome was a decrease in menstrual bleeding as assessed by pictorial blood loss assessment charts and hematological parameters analyzed at the 1st, 3rd and 6th months. Health-related quality of life (QOL) variables were also recorded and analyzed. Results: Twenty-eight patients were enrolled in each treatment group, but the results of only 62 were evaluated. NETA, tranexamic acid, and LNG-IUS reduced menstrual blood loss (MBL) by 53.1, 60.8, and 85.8%, respectively, at the 6th month. LNG-IUS was more effective than NETA and tranexamic acid in decreasing MBL. LNG-IUS was also more efficient than tranexamic acid in correcting anemia related to menorrhagia. Satisfaction rates were comparable among the NETA (70%), tranexamic acid (63%) and LNG-IUS (77%) groups. QOL in physical aspects increased significantly in the tranexamic acid and LNG-IUS groups. Conclusion: The positive effect of LNG-IUS on QOL parameters, as well as its high efficacy, makes it a first-line option for HMB.

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Section: Discussionsupporting

confidence: 80%

Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study

Kiseli

Kayıkçıoğlu

Evliyaoğlu

et al. 2016

Gynecol Obstet Invest

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“…The demonstration of high levels of endometrial fibrinolytic activity in women with menorrhagia provides a rationale for their use in this setting [62,63]. Several studies reported that tranexamic acid reduced objectively confirmed menstrual blood loss by 34-59% compared to baseline or placebo in women with idiopathic menorrhagia not due to bleeding disorders [47,[64][65][66][67]. A recent meta-analysis found a similar 47% reduction in mean menstrual blood loss [68].…”

Section: Antifibrinolytic Therapymentioning

confidence: 99%

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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“…Several studies of variable design have been carried out to assess the therapeutic efficacy of tranexamic acid in the treatment of idiopathic menorrhagia [166][167][168][169][170]. Using oral tranexamic acid ranging from 500 mg or 1 g four times daily for 4-7 days per cycle, the menstrual blood loss was reduced by 34-59% over two to three cycles in women with menorrhagia.…”

Section: Medical Treatment Of Menorrhagiamentioning

confidence: 99%

The obstetric and gynaecological management of women with inherited bleeding disorders – review with guidelines produced by a taskforce of UK Haemophilia Centre Doctors’ Organization

et al. 2006

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Summary. The gynaecological and obstetric management of women with inherited coagulation disorders requires close collaboration between obstetrician/ gynaecologists and haematologists. Ideally these women should be managed in a joint disciplinary clinic where expertise and facilities are available to provide comprehensive assessment of the bleeding disorder and a combined plan of management. The haematologist should arrange and interpret laboratory tests and make provision for appropriate replacement therapy. These guidelines have been provided for healthcare professionals for information and guidance and it is also intended that they are readily available for women with bleeding disorders.

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Treatment of Menorrhagia with Tranexamic Acid. A Double-blind Trial

Cited by 113 publications

References 7 publications

Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study

Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study

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

The obstetric and gynaecological management of women with inherited bleeding disorders – review with guidelines produced by a taskforce of UK Haemophilia Centre Doctors’ Organization

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