Danazol in the Treatment of Menorrhagia

Summary

The most commonly used medical therapies for the treatment of menorrhagia have been progestogens alone or combined with an oestrogen, and antifibrinolytic drugs. Most recently, prostaglandin synthetase inhibitors have been shown to reduce menstrual blood loss in some women. This paper reviews the use of danazol in the treatment of women complaining of regular but heavy menstrual blood loss and in whom objective measurements of blood loss were made. 18 patients with menorrhagia (more than 80ml menstrual blood loss) were treated with danazol 400mg daily for 12 weeks. Danazol significantly reduced the menstrual blood loss from 231 ± 39ml (mean ± SEM) to 135 ± 33 ml in the first treatment month, and the mean loss thereafter was only 21ml and 3ml for the second and third months respectively. A rapid increase in haemoglobin level, and a reduction in the number of days of bleeding were also observed on danazol treatment. No important effect on the coagulation profile was observed during the period of study. 3 months after stopping danazol, menstrual blood loss (103 ± 27 ml) was still significantly less than the pretreatment loss. Because of side effects of weight gain and muscle cramps in some patients, a smaller dose of danazol, 200mg daily, has since been evaluated. This dose effectively reduced menstrual loss to acceptable amounts, with continuing regular menstrual periods in most women, and greatly reduced the incidence of side effects of the drug.