Role of tranexamic acid in management of dysfunctional uterine bleeding in comparison with medroxyprogesterone acetate.
Currently, tranexamic acid (TXA) is used as 4 g/day in menorrhagia This prospective randomised study included 100 cases to assess efficacy and safety of 2 g/day TXA in dysfunctional uterine bleeding (DUB) vs cyclical 10 mg twice-daily medroxyprogesterone acetate (MPA) for 3 cycles. Follow-ups were made monthly for 3 months during therapy, then 3 months after. Mean pictorial blood loss assessment chart (PBAC) score decreased from 356.9 to 141.6 in the TXA group and from the pre-treatment 370.9 to 156.6 with MPA and mean reduction of blood loss was 60.3% with TXA and 57.7% with MPA after 3 months (p < 0.005 in both groups). Lack of response during treatment was seen in three patients (6.1%) TXA and in 13 patients (28.9%) with MPA (p = 0.003). In patients who reported 3 months after stopping the treatment, 66.7% in TXA group and 50% in MPA had recurrence of menorrhagia, (p = 0.155). During the 6 months study period more hysterectomies were performed in the MPA than in the TXA group (17.8% vs 4%; p = 0.002). We conclude that TXA in 2 g/day dosage is an effective and safe option in DUB.
Kriplani
A
A
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Kulshrestha
V
V
Agarwal
N
N
Diwakar
S
S
D000293:Adolescent; D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D003280:Contraceptives, Oral, Synthetic / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008525:Medroxyprogesterone / Q000627:therapeutic use*; D008595:Menorrhagia / Q000188:drug therapy*; D008875:Middle Aged; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D003280:Contraceptives, Oral, Synthetic; D014148:Tranexamic Acid; D008525:Medroxyprogesterone