title: Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study.
abstract: BACKGROUND
  Our aim was to compare the therapeutic efficacies of norethisterone acid (NETA), tranexamic acid and levonorgestrel-releasing intrauterine system (LNG-IUS) in treating idiopathic heavy menstrual bleeding (HMB).
  
  
  METHODS
  Women with heavy uterine bleeding were randomized to receive NETA, tranexamic acid or LNG-IUS for 6 months. The primary outcome was a decrease in menstrual bleeding as assessed by pictorial blood loss assessment charts and hematological parameters analyzed at the 1st, 3rd and 6th months. Health-related quality of life (QOL) variables were also recorded and analyzed.
  
  
  RESULTS
  Twenty-eight patients were enrolled in each treatment group, but the results of only 62 were evaluated. NETA, tranexamic acid, and LNG-IUS reduced menstrual blood loss (MBL) by 53.1, 60.8, and 85.8%, respectively, at the 6th month. LNG-IUS was more effective than NETA and tranexamic acid in decreasing MBL. LNG-IUS was also more efficient than tranexamic acid in correcting anemia related to menorrhagia. Satisfaction rates were comparable among the NETA (70%), tranexamic acid (63%) and LNG-IUS (77%) groups. QOL in physical aspects increased significantly in the tranexamic acid and LNG-IUS groups.
  
  
  CONCLUSIONS
  The positive effect of LNG-IUS on QOL parameters, as well as its high efficacy, makes it a first-line option for HMB.
authors.affiliation: Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecology Clinic, Ankara, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Kiseli
authors.forename: Fulya
authors.initials: F
authors.lastname: Kayikcioglu
authors.forename: Ozlem
authors.initials: O
authors.lastname: Evliyaoglu
authors.forename: Ali
authors.initials: A
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology / Q000628:therapy; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008595:Menorrhagia / Q000188:drug therapy*; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage*; D012102:Reproductive Control Agents / Q000008:administration & dosage*; D014148:Tranexamic Acid / Q000008:administration & dosage*
chemical_list: D006490:Hemostatics; D012102:Reproductive Control Agents; D016912:Levonorgestrel; D014148:Tranexamic Acid; D009640:Norethindrone