Document Detail


Tranexamic acid for the treatment of heavy menstrual bleeding: efficacy and safety.
MedLine Citation:
PMID:  22956886     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Tranexamic acid has proven to be an effective treatment for heavy menstrual bleeding (HMB). It reduces menstrual blood loss (MBL) by 26%-60% and is significantly more effective than placebo, nonsteroidal anti-inflammatory drugs, oral cyclical luteal phase progestins, or oral etamsylate, while the levonorgestrel-releasing intrauterine system reduces MBL more than tranexamic acid. Other treatments used for HMB are oral contraceptives, danazol, and surgical interventions (endometrial ablation and hysterectomy). Medical therapy is usually considered a first-line treatment for idiopathic HMB. Tranexamic acid significantly improves the quality of life of women treated for HMB. The recommended oral dosage is 3.9-4 g/day for 4-5 days starting from the first day of the menstrual cycle. Adverse effects are few and mainly mild. No evidence exists of an increase in the incidence of thrombotic events associated with its use. An active thromboembolic disease is a contraindication. In the US, a history of thrombosis or thromboembolism, or an intrinsic risk for thrombosis or thromboembolism are considered contraindications as well. This review focuses on the efficacy and safety of tranexamic acid in the treatment of idiopathic HMB. We searched for medical literature published in English on tranexamic acid from Ovid Medline, PubMed, and Cinahl. Additional references were identified from the reference lists of articles. Ovid Medline, PubMed, and Cinahl search terms were "tranexamic acid" and "menorrhagia" or "heavy menstrual bleeding." Searches were last updated on March 25, 2012. Studies with women receiving tranexamic acid for HMB were included; randomized controlled studies with a description of appropriate statistical methodology were preferred. Relevant data on the physiology of menstruation and the pharmacodynamics and pharmacokinetics of tranexamic acid are also included.
Authors:
Henri Leminen; Ritva Hurskainen
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Publication Detail:
Type:  Journal Article     Date:  2012-08-17
Journal Detail:
Title:  International journal of women's health     Volume:  4     ISSN:  1179-1411     ISO Abbreviation:  Int J Womens Health     Publication Date:  2012  
Date Detail:
Created Date:  2012-09-07     Completed Date:  2012-10-02     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  101531698     Medline TA:  Int J Womens Health     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  413-21     Citation Subset:  -    
Affiliation:
Department of Obstetrics and Gynecology, Hyvinkää Hospital, Hyvinkää, Finland.
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Comment In:
J Midwifery Womens Health. 2013 Mar-Apr;58(2):227-8   [PMID:  23590492 ]

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