Comparative study of tranexamic acid and norethisterone in the treatment of ovulatory menorrhagia

British Journal of Obstetrics and Gynaecology
J T PrestonS K Smith


To compare the efficacy and safety of tranexamic acid and norethisterone in the treatment of ovulatory menorrhagia. A randomised, double-blind, placebo controlled study. University Department of Obstetrics and Gynaecology, Addenbrooke's Hospital, Cambridge. One hundred and three women complaining of heavy periods with a regular cycle recruited directly from general practitioners within the hospital catchment area and from consultants' gynaecology clinics. There were forty-six women on placebo with confirmed ovulatory menorrhagia, defined as menstrual blood loss greater than 80 ml/cycle and mid-luteal serum progesterone concentration greater than 9 nmol/l). Twenty-one received norethisterone (5 mg twice a day on days 19 and 26) and 25 received tranexamic acid (1 g four times daily on days 1 to 4) for two cycles. Menstrual blood loss was measured using the alkaline haematin method. Haematological assessments were made both at the beginning and at the end of the study, questionnaires were given to assess subjective endpoints, and patients were asked to report any adverse events during all cycles. Tranexamic acid reduced mean menstrual blood loss by 45%, from 175 ml to 97 ml (95% CI for the difference in menstrual blood loss 52 to ...Continue Reading

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