Menorrhagia

Duckitt K, Kirsten Duckitt, Collins S, Sally Collins
BMJ clinical evidence · 2012 · vol. 2012 · PMID:22305976 · PMC3285230 · W4300507509
Systematic review / meta-analysis OA: closed CC0
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This systematic review evaluated the effectiveness and safety of various medical and surgical treatments for menorrhagia, including hormonal therapies, NSAIDs, and surgical interventions like hysterectomy.

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Abstract

INTRODUCTION: Menorrhagia limits normal activities, and causes anaemia in two-thirds of women with objective menorrhagia (loss of 80 mL blood per cycle). Prostaglandin disorders may be associated with idiopathic menorrhagia, and with heavy bleeding due to fibroids, adenomyosis, or use of intrauterine devices (IUDs). Fibroids have been found in 10% of women with menorrhagia overall, and in 40% of women with severe menorrhagia; but half of women having a hysterectomy for menorrhagia are found to have a normal uterus. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical treatments for menorrhagia? What are the effects of surgical treatments for menorrhagia? What are the effects of endometrial thinning before endometrial destruction in treating menorrhagia? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations, such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 39 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following medical interventions: combined pill, danazol, etamsylate, gonadorelin analogues, intrauterine progesterone, non-steroidal anti-inflammatory drugs (NSAIDs), progestogens, and the following surgical interventions: dilatation and curettage, endometrial destruction, and hysterectomy.

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Condition tags

adenomyosis

MeSH descriptors

Endometrial Ablation Techniques Endometrial Ablation Techniques Menorrhagia Menorrhagia Menorrhagia Administration, Oral Administration, Oral Danazol Danazol Danazol Dilatation and Curettage Dilatation and Curettage Female Female Humans Humans Intrauterine Devices, Medicated Intrauterine Devices, Medicated Progestins Progestins

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Cites (4)

References (37)

Source provenance

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License: CC0 · commercial use OK