title: Oral Tranexamic Acid versus Combined Oral Contraceptives for Adolescent Heavy Menstrual Bleeding: A Pilot Study.
abstract: OBJECTIVE
  To compare the efficacy of oral tranexamic acid (TA) with combined oral contraceptives (COC) in reducing menstrual blood loss (MBL) and improving quality of life in adolescent heavy menstrual bleeding (HMB).
  
  
  METHODS
  A prospective randomized crossover trial with 17 postmenarchal girls aged 21 years and younger with HMB who were seen at our institution.
  
  
  METHODS
  Patients were randomized to group A (TA arm) or group B (COC arm), each for 3 cycles, with crossover to the second arm after 1-month washout.
  
  
  METHODS
  The primary end points were difference in improvement in MBL and QOL, from baseline to end of each therapy.
  
  
  RESULTS
  Seventeen patients were enrolled (mean age 14.2 years, range 11.7 to 16.8 years). Nine patients completed both arms; 8 patients withdrew from the study due to adverse events or noncompliance. Compared with baseline, significant improvement (P < .05) was demonstrated by TA and COC in MBL (mean Pictorial Blood Assessment Chart score decrease: TA, 536.4; COC, 430.6) and quality of life (mean Pediatric Quality of Life Inventory(TM) version 4.0 Generic Scales score increase: TA, 15.6; COC, 16.75), but no significant difference was noted between TA and COC (P > .05). There was statistically significant reduction in the length of menstrual cycle for COC only (mean reduction 5.3 days; P = .04) and not for TA (P = .18). Ten patients (58%) experienced adverse events that were possibly drug related (TA: n = 3, 30%; COCP: n = 7, 64%).
  
  
  CONCLUSIONS
  In this pilot study, oral TA appeared as efficacious as COC in the management of adolescent HMB by reducing MBL and improving quality of life.
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas. Electronic address: lvsrivat@txch.org.
authors.forename: Lakshmi V
authors.initials: LV
authors.lastname: Srivaths
authors.affiliation: Department of Pediatric and Adolescent Gynecology, Texas Children's Hospital, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Dietrich
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Yee
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors.forename: Haleh
authors.initials: H
authors.lastname: Sangi-Haghpeykar
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas.
authors.forename: Donald
authors.initials: D
authors.lastname: Mahoney
mesh_terms: D000293:Adolescent; D002648:Child; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000188:drug therapy*; D008598:Menstruation / Q000187:drug effects*; D010349:Patient Compliance; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D014148:Tranexamic Acid / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; D014148:Tranexamic Acid
keywords: Adolescent; Heavy menstrual bleeding; Tranexamic acid