Treatment of heavy menstrual bleeding of endometrial origin: randomized controlled trial of medroxyprogesterone acetate and tranexamic acid
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This study aimed at comparing the efficacy of medroxyprogesterone acetate (MPA) and tranexamic acid (TA) for treating heavy menstrual bleeding of endometrial origin (HMB).
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, χ2, Mann–Whitney, Wilcoxon signed-rank test, and repeated measure analysis.
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).
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.
KeywordsHeavy menstrual bleeding of endometrial origin medroxyprogesterone acetate Randomized controlled trial Tranexamic acid
This study was funded by Tarbiat Modares University research office as part of a Midwifery Master of Science dissertation.
Conflict of interest
The authors have no conflicts to disclose.
- 2.Srinil S, Jaisamrarn U (2005) Treatment of heavy menstrual bleeding of endometrial origin with tranexamic acid. Med Assoc Thail 88:1Google Scholar
- 7.National Institute for Health and Clinical Excellence (2007) Heavy menstrual bleeding. National Institute for Health and Clinical Excellence (NICE). Clinical Guideline 44. LondonGoogle Scholar
- 11.Lethaby A, Irvine G, Cameron I (2008) Cyclical progestogens for heavy menstrual bleeding. Cochrane Database Syst Rev 23(1):CD001016. doi: 10.1002/14651858.CD001016.pub2
- 12.Kucuk T, Ertan K (2008) Continuous oral or intramuscular medroxyprogesterone acetate versus the levonorgestrel releasing intrauterine system in the treatment of perimenopausal HMB: a randomized, prospective, controlled clinical trial in female smokers. Clin Exper Obstet Gynaecol 35(1):57–60Google Scholar
- 14.Keppel G Wickens TD (2007) Design and analysis, Prentice Hall, NJGoogle Scholar
- 17.Mazari Z, Goshtasebi A, Moukhah S, Saki F (2011) HMB Questionnaire (MQ): translation and validation study of the Iranian version. Payesh 11:83–88Google Scholar