Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding
Non-steroidal anti-inflammatory drugs (NSAIDs) help reduce heavy menstrual bleeding (HMB) but tranexamic acid, danazol or levonorgestrel-releasing intrauterine system (LNG IUS) work better. Women seek help for HMB when it impacts on their quality of life although the menstrual loss can be assessed objectively. Levels of prostaglandin (naturally occurring fatty acids) are higher in women with HMB and are reduced by NSAIDs. The review of trials found that NSAIDs are modestly effective in reducing HMB but danazol, tranexamic acid and LNG IUS are more effective. Danazol caused a shorter duration of bleeding and more adverse effects than NSAIDs but this did not stop women using it. These results were based on a small number of underpowered trials.
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