Treatment of heavy menstrual bleeding of endometrial origin: randomized controlled trial of medroxyprogesterone acetate and tranexamic acid

Abstract

Long-term use of MPA is as effective as Tranexamic acid in treating HMB and increasing quality of life. However, bleeding irregularity side effects of MPA might limit its use.

Comparing the Effects of Tranexamic Acid and Medroxyprogestrone on Puerperal Bleeding

“…In this study, puerperal bleeding in patients treated with TXA had significant reduction compared with MP. The study of Goshtasebi, et al [27] on comparing the effects of TXA with MPA in the treatment of heavy menstrual bleeding of endometrial origin showed that duration of bleeding and Hb values as well as quality of life were significantly improved in both groups, But there was no significant deference between groups. More drug complication and less satisfaction were reported by MPA group [27].…”

“…The study of Goshtasebi, et al [27] on comparing the effects of TXA with MPA in the treatment of heavy menstrual bleeding of endometrial origin showed that duration of bleeding and Hb values as well as quality of life were significantly improved in both groups, But there was no significant deference between groups. More drug complication and less satisfaction were reported by MPA group [27]. In the present study, puerperal bleeding and Hb levels were significantly improved in both groups and this improvement in group TXA was significantly greater than group MP.…”

Pictorial methods to assess heavy menstrual bleeding in research and clinical practice: a systematic literature review

“…Most charts referenced the scoring system of Higham et al and, to a lesser extent, Janssen et al, although several modifications were made. The brand(s) of sanitary products were stated for some PBACs [15,[41][42][43][44][45] but not for others [46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]. The icon illustrations were often different and/or the individual scores were altered, whether by error or by design [41, 43, 46-49, 51, 52, 55-57, 60-63, 66, 67].…”

“…The appropriate time point to test efficacy will need to be considered, subject to the type and purpose of therapy. Medical treatments designed to rapidly reduce MBL tend to have short follow-up times of between 1 month and 12 months [44,[110][111][112][113], whereas surgical interventions, such the levonorgestrel intrauterine system and endometrial ablation, are designed for long-term reduction of MBL. Monitoring of menstrual loss has been reported for up to 5 years after surgery at various time intervals, depending on the study [59,106,107,114].…”

Direct Oral Anticoagulants and Women

“…Tranexamic acid (TA), a lysine analog that can reversibly bind both circulating and fibrin-bound plasminogen and thus inhibit fibrinolysis, has proven efficacy in reducing the severity of HMB possibly by improving clot stability in the uterine mucosa. 54 A meta-analysis of four RCTs showed that antifibrinolytic therapy compared with placebo showed a significant reduction in mean blood loss (weighted mean difference [WMD]: À94.0, 95% CI: À151.4 to À36.5]) and significant change in mean reduction of blood loss (WMD À110.2, 95% CI: À146.5 to À73.8]). This objective improvement was not mirrored by a patient-perceived improvement in monthly menstrual blood loss (RR: 2.5, 95% CI: 0.9-7.3) in the one study that recorded this outcome.…”