Medical management of heavy menstrual bleeding: a comprehensive review of the literature

Obstetrical & Gynecological Survey
Johannes BitzerIan S Fraser

Abstract

Heavy menstrual bleeding (HMB) is a common complaint among reproductive-aged women, which negatively affects their health as well as their social, professional, and family lives. Modern medical management usually provides effective control of HMB irrespective of the underlying cause. Surgical interventions should be reserved for women with significant pelvic pathology and those unresponsive to medical therapy. The aim of this review was to provide a comprehensive summary of the efficacy and safety of available medical treatments of HMB. A comprehensive MEDLINE and EMBASE literature search was undertaken using selected terms associated with HMB to identify clinical studies published before March 20, 2013, that reported changes in menstrual blood loss in women receiving medical intervention. The effectiveness of treatments to reduce HMB due to endometrial dysfunction in descending order was as follows: (1) the levonorgestrel-releasing intrauterine system (LNG-IUS) (initial release rate of 20 μg of LNG per 24 hours), (2) combined hormonal contraceptives (oral or transvaginal), (3) tranexamic acid, and (4) long-course oral progestogens (≥3 weeks per cycle). The LNG-IUS was found to reduce HMB due to some structural causes (leiomyom...Continue Reading

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Citations

Feb 28, 2017·Best Practice & Research. Clinical Obstetrics & Gynaecology·Oskari Heikinheimo, Ian Fraser
Mar 7, 2017·Thrombosis Research·Joanna Davies, Rezan A Kadir
May 1, 2016·Reproductive Sciences·Tarita PakrashiTerry Jacot
Aug 20, 2019·The Cochrane Database of Systematic Reviews·Magdalena Bofill RodriguezIain T Cameron
Dec 31, 2019·JAMA Pediatrics·Claudia Borzutzky, Julie Jaffray
Dec 5, 2017·Contraception and Reproductive Medicine·Intira SriprasertDavid F Archer
Feb 2, 2018·The Medical Journal of Australia·Annabelle Brennan, Martha Hickey
Jul 12, 2016·Phytotherapy Research : PTR·Roghayeh JavanHamideh Naghedi-Baghdar
Dec 10, 2020·Journal of Clinical Medicine·Jacques Donnez
Dec 12, 2018·American Journal of Obstetrics and Gynecology·Jill E SergisonDavid Hubacher
Sep 1, 2021·Journal of Menopausal Medicine·Jong-Kil JooMee-Ran Kim

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