Antifibrinolytics for heavy menstrual bleeding

The Cochrane Database of Systematic Reviews
I CookeC Farquhar

Abstract

Heavy menstrual bleeding (HMB) is an important cause of ill health in women. Medical therapy, with the avoidance of possibly unnecessary surgery, is an attractive treatment option. A wide variety of medications are available to reduce heavy menstrual bleeding but there is considerable variation in practice and uncertainty about the most appropriate therapy. Plasminogen activators are a group of enzymes that cause fibrinolysis (the dissolution of clots). An increase in the levels of plasminogen activators has been found in the endometrium of women with heavy menstrual bleeding compared to those with normal menstrual loss. Plasminogen activator inhibitors (antifibrinolytic agents) have therefore been promoted as a treatment for heavy menstrual bleeding. There has been a reluctance to prescribe tranexamic acid due to possible side effects of the drugs such as an increased risk of thrombogenic disease (deep venous thrombosis). Long term studies in Sweden, however, have shown that the rate of incidence of thrombosis in women treated with tranexamic acid is comparable with the spontaneous frequency of thrombosis in women. To determine the effectiveness of antifibrinolytics in achieving a reduction in heavy menstrual bleeding. All stu...Continue Reading

Citations

May 25, 2011·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Kari Hilde Juvkam, Hilde Beate Gudim
Jan 11, 2012·Acta Obstetricia Et Gynecologica Scandinavica·Becky Naoulou, Ming C Tsai
Apr 16, 2018·The Cochrane Database of Systematic Reviews·Alison C Bryant-SmithMartha Hickey
Nov 3, 2016·The Cochrane Database of Systematic Reviews·Gabriela PrutskyRoberto Accinelli
Sep 22, 2016·Journal of Obstetrics and Gynaecology of India·Priyankur RoyBivas Biswas
Jun 17, 2015·The Cochrane Database of Systematic Reviews·Natalia NovikovaCatherine Cluver
Nov 3, 2012·Archives of Gynecology and Obstetrics·Hatem Abu Hashim
Dec 1, 2011·Hämostaseologie·S Halimeh
Nov 15, 2016·The Cochrane Database of Systematic Reviews·Sujoy Ray, Amita Ray
Sep 22, 2016·Journal of Obstetrics and Gynaecology of India·Priyankur RoyAnumita Chatterjee
Jan 29, 2016·The Cochrane Database of Systematic Reviews·Jane MarjoribanksCindy Farquhar

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