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Related Experiment Videos

Cyclical progestogens for heavy menstrual bleeding.

A Lethaby1, G Irvine, I Cameron

  • 1Department of Obstetrics and Gynaecology, University of Auckland, 2nd Floor, National Women's Hospital, Claude Road, Epsom, Auckland, New Zealand. a.lethaby@auckland.ac.nz

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary
This summary is machine-generated.

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See all related articles

Oral progestogens are not effective for heavy menstrual bleeding (HMB). Tranexamic acid, danazol, and the levonorgestrel intrauterine system (LNG IUS) are more effective treatments for reducing menstrual blood loss.

Area of Science:

  • Gynecology
  • Pharmacology
  • Evidence-based Medicine

Background:

  • Heavy menstrual bleeding (HMB) significantly impacts women's health.
  • Medical therapy is preferred over surgery for HMB when no anatomical pathology is present.
  • Oral progestogens are commonly prescribed for HMB despite limited evidence, particularly in ovulatory cycles.

Purpose of the Study:

  • To evaluate the efficacy of oral progestogen therapy for reducing menstrual blood loss in women with HMB.
  • To compare two regimens: luteal phase progestogen use versus 21-day progestogen use.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches.
  • Inclusion criteria: RCTs comparing oral progestogens with placebo or other medical treatments for regular HMB without pathological causes.

Related Experiment Videos

  • Data extraction and analysis included odds ratios and weighted mean differences.

    • Main Results:

    • No RCTs compared oral progestogens directly with placebo.
    • Luteal phase progestogens were less effective than tranexamic acid, danazol, and the progesterone-releasing intrauterine system (IUS), with a trend favoring NSAIDs.
    • 21-day progestogen therapy (norethisterone) was less effective than the LNG IUS, with lower patient acceptability and higher rates of adverse events.

    Conclusions:

    • Oral progestogen therapy shows limited effectiveness in reducing menstrual blood loss for HMB.
    • Alternative treatments like tranexamic acid, danazol, and the LNG IUS demonstrate superior efficacy.
    • Further research is needed to establish optimal medical management for HMB.