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tranexamic acid in the treatment of heavy menstrual bleeding
Acta Obstet Gynecol Scand. 2012 Jan 10. doi: 10.1111/j.1600-0412.2012.01361.x.
Efficacy of tranexamic acid in the treatment of idiopathic and non-functional heavy menstrual bleeding: A systematic review.
Naoulou B, Tsai MC.
Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York, USA.
Objective. To evaluate the efficacy of tranexamic acid in the treatment of idiopathic and non-functional heavy menstrual bleeding.
Design. Systematic review. Population: Women with diagnosis of idiopathic and non-functional heavy menstrual bleeding treated with tranexamic acid.
Method. Electronic searches were conducted in literature database up to February 2011 by 2 independent reviewers. We included all trials involving efficacy of tranexamic acid for the treatment of heavy uterine bleeding. Pregnant, postmenopausal and cancer patients were excluded.
Main outcome measures. Effect of tranexamic acid treatment on objective reduction of menstrual bleeding and improvement of patient quality of life.
Results. A total of 10 studies met our inclusion criteria. Available evidence, indicates that tranexamic acid therapy in idiopathic menorrhagia women resulted in 34-54% reduction in menstrual blood loss compared to. Following tranexamic acid treatment patient's life quality parameters improved by 46-83% compared to 15-45% with norethisterone. When compared to placebo, tranexamic acid use significantly decreased the blood loss by 70% in women with menorrhagia secondary to intrauterine device (P<0.001). Limited evidence indicated potential benefit in fibroid patients with menorrhagia. No thromboembolic event was reported in all studies analyzed.
Conclusion. Available evidence indicated that tranexamic acid treatment is effective and safe, and could potentially improve quality of life of patients presenting with idiopathic and non-functional heavy menstrual bleeding. Data on the therapeutic efficacy of tranexamic acid in patients with symptomatic fibroids is limited and further studies are therefore needed.
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