Non-surgical interventions for treating heavy menstrual bleeding (menorrhagia) in women with bleeding disorders

Desmopressin might possibly be effective for heavy menstrual bleeding compared to placebo in women with bleeding disorders. Tranexamic acid may be more effective than desmopressin.

Comment:The quality of evidence is downgraded by study limitations (unclear allocation concealment), by inconsistency (variability in results), and by imprecise results (few patients).

Summary

A Cochrane review included 3 cross-over studies with a total of 175 subjects. In two studies (n = 59) comparing desmopressin with placebo no clear difference between groups was found. The first of these reported a mean difference in menstrual blood loss in the desmopressin vs placebo group of 21.20 mL (95% confidence interval -19.00 to 61.50). In the second study there was no clear evidence of difference in pictorial bleeding assessment chart scores (PBAC). The third study comparing desmopressin with tranexamic acid (n = 116) found a decrease in PBAC after both treatments as compared to baseline. The decrease in these scores was greater for tranexamic acid than for desmopressin, with a mean difference of 41.6 mL (95% CI 19.6 to 63; P < 0.0002). In relation to adverse events, there was no clear difference when placebo was compared to desmopressin, or when desmopressin was compared to tranexamic acid.

Clinical comments

Date of latest search: 8 November 2016

Ədəbiyyat

1. Ray S, Ray A. Non-surgical interventions for treating heavy menstrual bleeding (menorrhagia) in women with bleeding disorders. Cochrane Database Syst Rev 2014;(11):CD010338 [Assessed as up-to-date: 8 November 2016].