Management of initial bleeding or spotting after levonorgestrel-releasing intrauterine system placement: a randomized controlled trial

Obstetrics and Gynecology
Terje SørdalThomas Schmelter

Abstract

To assess the efficacy of tranexamic acid or mefenamic acid in the management of the initial "nuisance" bleeding or spotting in the period immediately after placement of the levonorgestrel-releasing intrauterine system. Women were randomized after levonorgestrel-releasing intrauterine system placement to oral tranexamic acid (500 mg), mefenamic acid (500 mg), or placebo three times daily during bleeding or spotting episodes over a 90-day treatment period. Treatment was initiated from onset of a bleeding or spotting episode and continued until the first day after bleeding or spotting stopped and restarted with a new bleeding or spotting episode. The primary efficacy variable was reduction in the number of bleeding or spotting days. Tranexamic acid and mefenamic acid were compared with placebo using a one-sided Wilcoxon rank-sum test. Bonferroni-Holm adjustment was used to account for multiple testing. A total of 204 women were screened; 187 were randomized to tranexamic acid (n=63), mefenamic acid (n=63), or placebo (n=61). The median number of bleeding or spotting days experienced during treatment was 25, 29, and 33 days in the three groups, respectively. The median number of bleeding or spotting days was reduced by 6 days (95%...Continue Reading

References

Feb 14, 2006·Contraception·Vorapong PhupongSurasak Taneepanichskul
Mar 13, 2010·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Suman LalNutan Agarwal
Nov 8, 2011·American Journal of Obstetrics and Gynecology·Tessa MaddenJeffrey F Peipert

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Citations

May 1, 2015·European Heart Journal·Jolien W Roos-HesselinkMark R Johnson
Dec 19, 2016·American Journal of Obstetrics and Gynecology·Rachel E Zigler, Colleen McNicholas
Oct 25, 2017·Obstetrics and Gynecology·UNKNOWN Committee on Practice Bulletins-Gynecology, Long-Acting Reversible Contraception Work Group
May 3, 2013·Obstetrics and Gynecology·David E Soper
Nov 30, 2019·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Mariana FavaLuis Bahamondes
Apr 21, 2016·NPJ Microgravity·Varsha Jain, Virginia E Wotring
Sep 6, 2020·Current Opinion in Obstetrics & Gynecology·Andrea Henkel, Lisa M Goldthwaite

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