The effect of tranexamic acid for treatment irregular uterine bleeding secondary to DMPA use.
OBJECTIVE
Evaluate the efficacy of tranexamic acid and placebo for controlling irregular uterine bleeding in depot-medroxyprogesterone acetate (DMPA) users.


METHODS
A double-blind, placebo-controlled study was conducted on 100 DMPA users attending the Family Planning Clinic King Chulalongkorn Memorial Hospital. All users had abnormal bleeding. They were randomly divided in two groups; a group of 50 received tranexamic acid, 250 mg four times a day for 5 days and another group of 49 received placebo in the same manner. One subject dropped out from the study. Total day of bleeding/spotting and percentage of women in whom bleeding was stopped were analyzed at the end of weeks 1 and 4.


RESULTS
The percentage of subjects in whom bleeding was stopped during the first week after initial treatment was significantly higher in the tranexamic acid group than the placebo group (88% vs. 8.2%, p < 0.001). During the follow-up period (4 weeks after initial treatment), a bleeding-free interval of > 20 days was found in 68% of subjects treated with tranexamic acid and 0% treated with placebo(p < 0.001). The mean number of bleeding/spotting days were also significantly different between the groups (5.7 +/- 2.5 vs. 17.5 +/- 7.2 days, p < 0.05).


CONCLUSIONS
Tranexamic acid was more effective than placebo in short-term treatment of irregular uterine bleeding/spotting associated with DMPA use.
Senthong
A-Jaree
AJ
Deapartment of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. ajaree_s@hotmail.com
Taneepanichskul
Surasak
S
D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D003271:Contraceptive Agents, Female / Q000009:adverse effects*; D004311:Double-Blind Method; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects*; D008599:Menstruation Disturbances / Q000139:chemically induced / Q000188:drug therapy*; D008875:Middle Aged; D011247:Pregnancy; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000139:chemically induced / Q000188:drug therapy*
D000933:Antifibrinolytic Agents; D003271:Contraceptive Agents, Female; D014148:Tranexamic Acid; D017258:Medroxyprogesterone Acetate