Best Medical Treatment for Heavy Menstrual Bleeding

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Heavy menstrual bleeding is not a life-threatening phenomenon, but can cause women anxious and is a social problem. These women have increased amounts of endogenous plasminogen activators that cause clots to dissolve. 

Current option approved by the US Food and Drug Administration to treat heavy menstrual bleeding include hormonal treatments and surgery. 

Now, a study presented at the American Congress of Obstetricians and Gynecologists 59th Annual Clinical Meeting, indicated that oral tranexamic acid (TA) significantly reduced menstrual blood loss in women with heavy menstrual bleeding.  The efficacy of blood loss reductions was durable throughout the 6 months and the safety of this agent was comparable to placebo. 

TA is an antifibrinolytic agent that makes the clot stronger.  It is marketed as Lysteda and in IV form as Cyklokapron in the U.S.and as Transamin,Transcam in Asia, and Espercil inSouth America. 

The study enrolled 196 women with heavy menstrual bleeding at 40 sites in theUnited States. Subjects were randomly given either TA or placebo 3 times a day for a maximum of 5 days per cycle and continued for 6 cycles. 

TA-treated women achieved significant reductions in menstrual blood loss (-69.6ml) when compared with subjects randomized to placebo (-12.6ml).

Furthermore, the reduction in blood loss with TA occurred during the first treatment cycle and was maintained for 6 cycles. 

The drug was well tolerated.  During the study, a similar percentage of subjects in the TA and placebo groups experienced GI events (31.6% vs 37.5%).  No subject in the TA group experienced a thrombotic or thromboembolic event.  

Any women with heavy menstrual bleeding should ask their doctors about this drug. 

Source: American Congress of Obstetricians and Gynecologists (ACOG) 59th Annual Clinical meeting: Abstract 40.  Presented May 2, 2011.

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