title: Treatment of heavy menstrual bleeding of endometrial origin: randomized controlled trial of medroxyprogesterone acetate and tranexamic acid.
abstract: OBJECTIVE
  This study aimed at comparing the efficacy of medroxyprogesterone acetate (MPA) and tranexamic acid (TA) for treating heavy menstrual bleeding of endometrial origin (HMB).
  
  
  METHODS
  A randomized controlled trial was carried out in three gynecology clinics in Tehran, Iran. Ninety women with the HMB of endometrial origin were randomized into the study: 44 patients took MPA for 21 days from day 5 and 46 patients took tranexamic acid for 5 days from day 1 of menses for three consecutive menstrual cycles. Blood loss was measured using the pictorial blood loss assessment chart (PBAC); hematological assessments were made before intervention and after treatment. SF-36 and HMB Questionnaire (MQ) were given to assess quality of life. Statistical analysis was performed using t test, Paired t test, χ(2), Mann-Whitney, Wilcoxon signed-rank test, and repeated measure analysis.
  
  
  RESULTS
  PBLC mean score, duration of bleeding and Hb values as well as quality of life were significantly improved in both groups (P < 0.05). But there was no significant deference between groups. More drug complication and less satisfaction were reported by MPA group (P = 0.003 and P = 0.002, respectively).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family Health, Mother and Child Health Research Center, Iranian Institute for Health Sciences Research, ACECR, No 23, Nazari St, South Palestine St, Enghelab Ave, 13145-1756, Tehran, Iran, agoshtasebi@ihsr.ac.ir.
authors.forename: Azita
authors.initials: A
authors.lastname: Goshtasebi
authors.forename: Somayeh
authors.initials: S
authors.lastname: Moukhah
authors.forename: Samira Behboudi
authors.initials: SB
authors.lastname: Gandevani
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000627:therapeutic use*; D004717:Endometrium; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects / Q000627:therapeutic use*; D008595:Menorrhagia / Q000188:drug therapy*; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014148:Tranexamic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000933:Antifibrinolytic Agents; D003271:Contraceptive Agents, Female; D014148:Tranexamic Acid; D017258:Medroxyprogesterone Acetate