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Therapies for the treatment of abnormal uterine bleeding
1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Cincinnati, Cincinnati, OH, USA. robinjr@ucmail.edu
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Abnormal uterine bleeding (AUB) treatments include medications and devices. Medicated intrauterine devices (IUDs) significantly reduce menstrual blood loss, offering an effective option for menorrhagia.
Area of Science:
- Gynecology
- Reproductive Medicine
Background:
- Abnormal uterine bleeding (AUB) is a common gynecological disorder.
- Menorrhagia, characterized by excessive menstrual bleeding, affects many women.
Purpose of the Study:
- To review current pharmacological and device-based treatments for menorrhagia.
- To evaluate the efficacy of various interventions in reducing menstrual blood loss.
Main Methods:
- Review of existing literature on treatments for AUB and menorrhagia.
- Comparison of efficacy and side effect profiles of different therapeutic options.
Main Results:
- Non-steroidal anti-inflammatory drugs reduce bleeding by 30-50%.
- Oral contraceptives and tranexamic acid decrease flow by approximately 50%.
- Medicated intrauterine devices (IUDs) reduce blood loss by 65-85%.
Conclusions:
- Medicated IUDs offer significant reduction in menstrual blood loss.
- Minimally invasive surgical procedures and office-based ablations are options for select patients.
- While some drugs are effective, long-term use may be limited by side effects.
Abstract:
Abnormal uterine bleeding (AUB) is one of the most common disorders encountered by the gynecologist. Several drugs have been demonstrated to decrease menstrual bleeding in patients with menorrhagia. Non-steroidal anti-inflammatory drugs will decrease bleeding by 30% to 50%. Oral contraceptives may be useful to stop acute bleeding and will decrease menstrual flow by approximately 50%. Tranexamic acid, a plasminogen inhibitor approved for the treatment of hemophilia, will also decrease flow by approximately 50%. Danazol and GnRH analogues both have been used for the treatment of menorrhagia. However, side effects make them unsuitable for long-term use. There are currently two medicated intrauterine devices (IUDs) available in the United States. These IUDs reduce menstrual blood loss by 65% to 85%. Several minimally invasive surgical procedures, including endometrial resection and ablation, may treat menorrhagia in select patients. More recently, various office-based ablation instruments have been developed. These machines conform to the endometrial cavity and may obviate the need for hysteroscopy.