The influence of acetylsalicylic acid and paracetamol on menstrual blood loss in women with and without an intrauterine contraceptive device

Effect of Small Doses of Aspirin and Acetaminophen on Total Menstrual Loss and Pain of Cramps and Headache

“…Furthermore, at these doses, neither aspirin nor acetamino phen exerted a sufficient antiprostaglandin effect to reduce total menstrual loss. This finding is expected since for aspirin previous trials with 500-to 650-mg doses 4 times a day have not altered flow [3,4]; furthermore, 2 X 325 mg acetaminophen 4 times a day for 3 days did not alter flow [5], Although neither drug produced an altera tion in menstrual loss, both medications were more effective than placebo (p = 0.0072) in reducing pain of cramps; neither appeared to be superior. This finding is unexpected con sidering previous reports that aspirin is not effective unless given prophylactically [1][2][3]7], In our previous study with a 3-day proto col rather than the 1 -day protocol used here we did not find that cither drug significantly reduced pain [5], Our results indicate that further studies to establish dose-response curves for aspirin and acetaminophen are needed.…”

“…With increasing awareness of the rela tionship between dysmenorrhea and prosta glandins, prostaglandin inhibitors are the medication of choice for cramps accompa nying menses [1,2], Of the prostaglandin inhibitors, aspirin and aspirin-like com pounds have been reported to be the least effective in reducing pain when given at over-the-counter doses [1,2); furthermore aspirin has a fibrinolytic action which, ac cording to some authors, should promote menstrual bleeding [3,4], Consequently aspi rin or aspirin-like drugs are not the first choice for a prescribing physician. Neverthe less.…”

Effects of antiplatelet therapy on menstrual blood loss in reproductive-aged women: a systematic review

“…In total, 742 records were identified by our database search, of which 607 potentially relevant unique articles were screened based on titles and abstracts ( Figure 1 ) [ 21 ]. Full-text screening was subsequently performed on 75 records, of which 13 studies were finally included [ [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ]. Excluded studies and reasons for exclusion are listed in the Supplementary material (Item 16b of PRISMA 2020 checklist).…”

“…Thirteen studies with a total of 611 women who used any type of antiplatelet drug were included [ [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ] ( Table 1 ). Seven studies had an experimental design: 3 (randomized) double-blind crossover studies [ [22] , [23] , [24] ], 3 randomized (double-blind) controlled trials [ 26 , 27 , 31 ], and 1 prospective study without control group [ 25 ]. The other studies had an observational design: 3 prospective cohort studies [ 28 , 30 , 34 ], 2 retrospective cohort studies [ 29 , 32 ], and 1 cross-sectional study [ 33 ].…”

Antiplatelet period drama: a rush of blood or classic crimson tide?

“…Less well described and of greater uncertainty is the impact of antiplatelet therapy on menstrual blood loss. Interestingly, aspirin and other nonsteroidal anti-inflammatory drugs have been hypothesized to reduce menstrual bleeding by inhibiting prostaglandin synthesis, leading to vasoconstriction in the endometrium [ 5 , 6 ]. Yet, aspirin as well as other neurovascular- and cardiovascular-protective agents such as P2Y12 inhibitors increase risk of systemic bleeding due to their antiplatelet effects.…”