Reduction of menstrual blood loss by prostaglandin inhibitors

Nuffield Department of Obstetrics and Gynœcology, John Radcliffe Hospital, University of Oxford, Headington, Oxford, United Kingdom
The Lancet (Impact Factor: 45.22). 05/1976; 1(7963):774-6. DOI: 10.1016/S0140-6736(76)91612-3
Source: PubMed


Six patients with menorrhagia due to dysfunctional uterine bleeding and one patient with an intrauterine contraceptive device were treated with prostaglandin-synthetase inhibitors in an attempt to reduce their excessive menstrual blood-loss. Mefenamic acid (six patients) or flufenamic acid (one patient) taken during menstruation for 2-3 cycles reduced menstrual loss in each patient. These preliminary observations suggest a new treatment for a common gynaecological problem and could imply that prostaglandins are involved in the aetiology of excessive menstrual blood-loss in such patients.

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    ABSTRACT: The clinical efficiency of indomethacin and tolfenamic acid in the treatment of primary dysmenorrhea was studied in a prospective placebo-controlled double-blind crossover study comprising 27 voluntary patients aged 16–28.The patients used either indomethacin (25 mg t.i.d.), tolfenamic acid (133 mg t.i.d.) or placebo for 4 days during 2 consecutive menstruations, starting 2 days before the menstruation. The general judgement of the patients was good or moderate in 87% of the cases during 49 indomethacin cycles, in 88% during 51 tolfenamic acid cycles, and in 47% during 49 placebo cycles. An alleviation of pelvic pain, lower back pain, nausea or vomiting and diarrhea was obtained by indomethacin in 79%, 91%, 83% and 84% of the cases, respectively. For tolfenamic acid the corresponding values were 67%, 77%, 86% and 55%, and for placebo 34%, 42%, 61% and 46%. A ‘dysmenorrhea score’ based on subjective estimation of 8 dysmenorrheic symptoms showed that the relief obtained by indomethacin or tolfenamic acid was significantly better than that by placebo. Indomethacin tended to be more effective than tolfenamic acid, though the difference was not statistically significant. Indomethacin and tolfenamic acid diminished the volume of menstrual bleeding and significantly reduced absence from work.
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