Medical Treatment of Menorrhagia

Indications

• Dysfunctional uterine bleeding

• Bleeding due to blood disorders

  • Von Willebrands disease

  • Thrombocytopenia

• Systemic diseases

• Temporary period before surgery to correct anaemia

• Refuses surgical interventions

• Associated factors

  • contraception

  • reduction in size of fibroids

Drugs

• NSAIDs

  • Inhibit prostaglandin synthesis
  • e.g. mefenamic acid, flufenamic acid
• Progesterones (progestagens)
• Oestrogen and progesterone
  • (Combined oral contraceptive pill, OCP)
• Antifibrinolytics
  • e.g. tranexamic acid
• Antigonadotrophins
  • e.g. danazol
• Ethamsylate
• GnRH analogues
  • Goserelin (Zoladex)
• Desmopressin
  • in Von Willebrands disease
• Mirena
  • Intra-uterine system
  • progesterone impregnated intrauterine device

Other measures

• correction of anaemia