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Re: Another Great Case From: Malcolm Griffiths (Malcolm@mgriff22.demon.co.uk) Thu Dec 25 13:44:39 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Malcolm Griffiths: "Re: Another Great Case" Previous message: Malcolm Griffiths: "Re: Magnesium Sulfate increases perinatal mortality??" In reply to: RModugno: "Re: Another Great Case" Next in thread: Bernard Cristalli: "Re: Another Great Case" In message <9402e1d8.34a1a155@aol.com>, RModugno <RModugno@aol.com> writes >In a message dated 97-12-23 21:27:50 EST, you write: > ><< Is this patient on any anti-inflammatory drugs for some reason? They can > promote menorrhagia. Just a thought.... > >> >I was under the impression that some NSAIDS could prevent menorrhagia. >Wasn't there a study with Ponstel ( Ponstan for the Brits!) which showed that >it decreased menstrual blood flow? > The study I quoted earlier in the week is hardly the definitive study on Ponstan (=Mefenamic acid), but th epaper and its references are relevant. My personal expereince is that it is particularly effective in heavy, painful periods - Dan help is that epidysmenorrhagia??? [ ;-) ] --- TI:Treatment of menorrhagia during menstruation: randomised controlled trial of ethamsylate, mefenamic acid, and tranexamic acid. AU:Bonnar J, Sheppard BL SO:BMJ YR:1996 VL:313 PG:579-82 AB: OBJECTIVE: To compare the efficacy and acceptability of ethamsylate, mefenamic acid, and tranexamic acid for treating menorrhagia. DESIGN: Randomised controlled trial. SETTING: A university department of obstetrics and gynaecology. SUBJECTS: 76 women with dysfunctional uterine bleeding. INTERVENTIONS: Treatment for five days from day 1 of menses during three consecutive menstrual periods. 27 patients were randomised to take ethamsylate 500 mg six hourly, 23 patients to take mefenamic acid 500 mg eight hourly, and 26 patients to take tranexamic acid 1 g six hourly. MAIN OUTCOMES MEASURES: Menstrual loss measured by the alkaline haematin method in three control menstrual periods and three menstrual periods during treatment; duration of bleeding; patient's estimation of blood loss; sanitary towel usage; the occurrence of dysmenorrhoea; and unwanted events. RESULTS: Ethamsylate did not reduce mean menstrual blood loss whereas mefenamic acid reduced blood loss by 20% (mean blood loss 186 ml before treatment, 148 ml during treatment) and tranexamic acid reduced blood loss by 54% (mean blood loss 164 ml before treatment, 75 ml during treatment). Sanitary towel usage was significantly reduced in patients treated with mefenamic acid and tranexamic acid. CONCLUSIONS: Tranexamic acid given during menstruation is a safe and highly effective treatment for excessive bleeding. Patients with dysfunctional uterine bleeding should be offered medical treatment with tranexamic acid before a decision is made about surgery. KY:Adult-; Menstruation-; Middle-Age; Patient-Acceptance-of-Health-Care; Patient-Satisfaction; Tampons-; *Antifibrinolytic-Agents-therapeutic- use; *Cyclooxygenase-Inhibitors-therapeutic-use; *Ethamsylate- therapeutic-use; *Hemostatics-therapeutic-use; *Mefenamic-Acid- therapeutic-use; *Menorrhagia-drug-therapy; *Tranexamic-Acid- therapeutic-use AN:MEDLINE 96399869 -- Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK. Tel: 01582-497459 (office) Fax: 01582-497376 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "CLINICAL FREEDOM IS THE LAST REFUGE OF THE CLINICALLY INCOMPETENT!" (Someone [1997]) Next message: Malcolm Griffiths: "Re: Another Great Case" Previous message: Malcolm Griffiths: "Re: Magnesium Sulfate increases perinatal mortality??" In reply to: RModugno: "Re: Another Great Case" Next in thread: Bernard Cristalli: "Re: Another Great Case"

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