Menorrhagia is defined as a condition of excessive
bleeding in the menstruation phase of the menstrual cycle in the
reproductive age of a woman leading to heavy blood loss that can
interfere with the woman normal activities, as a result of disruption of
normal hormonal regulation of periods or disorders of certain
reproductive organs.
Treatments
I. Conventional medicine
A. Primary menorrhagia
A.1.Ethamsylate
In a study of A double-blind trial of ethamsylate in the treatment
of primary and intrauterine-device menorrhagia by R F Harrison, S
Cambell, researchers found that During ethamsylate treatment the mean
menstrual blood-loss was reduced by 50% in patients with primary
menorrhagia and by 19% in patients with an I.U.C.D. This difference
between the two groups is probably accounted for by the differing values
of initial blood-loss which was significantly higher in the group with
primary menorrhagia.
A.2. Include those in the secondary menorrhagia with the recommendation of your doctor.
B. Secondary menorrhagia
B.1. Hormone treatments
1. Contraceptive pill
a. Low-dose combination birth control pills which contains
low-dose synthetic forms of the hormones estrogen and progesterone
may be use to treat amenorrhea by controlling the menstrual cycle or
bring the period back.
b. Risks and side effects
b.1. Growth of fibroids
Growth of fibroid is caused high level of estrogen and
progesterone. The intake of the pill increase the level of both
hormones resulting in increase the risk of growth of fibroid.
b.2. Recurrent of menstrual symptoms
Some women stop taking the pill may see all the menstrual symptoms coming back.
b3. Blood clots
Estrogen in the pill may cause blood clots in the small vessels in the leg and the lung.
b.4. Stroke and heart diseases
Study shows that women who have higher natural estrogen levels may have a higher risk of stroke and heart diseases.
b.5. Depression and mood swing
At the beginning, it may cause abnormal fluctuations in estrogen
and progesterone elevate both physical and psychological stress,
eventually resulting in both depression and mood swing
b.6. Bleeding and spotting
Bleeding and spotting is normal for the first six months for
women who begin with any oral contraceptive combination pill
treatment.
b.7. Lost interest in sex
Some women may experience lower sexual desire
b.8. Nutritional deficiency
Oral contraceptive pill causes vitamin and mineral imbalances or deficiencies.
b.9. Etc.
2. Norethisterone (Progesterone only pill)
Norethisterone a progestogen and has been used used treat
premenstrual syndrome, painful periods, abnormal heavy bleeding,
irregular periods. In a study of A comparative study of danazol and
norethisterone in dysfunctional uterine bleeding presenting as
menorrhagia M. Bonduelle, J.J. Walker and A.A. Caldert, researcher found
that Since this study was undertaken, a report of
objective measurement of blood loss in small groups of patients9 casts further doubt on the
efficacy ofnorethisterone, although it confirms that of danazol.
Since norethisterone is very widely used, a detailed assessment of its
efficacy and safety in comparison to danazol is overdue. Should such a
study confirm the findings discussed here then danazol could usefully be
employed as first line therapy in the management of dysfunctional
uterine bleeding presenting as menorrhagia.
3. Danazol
Danazol is synthetic steroid ethisterone, a modified testosterone
that is used to inhibit ovarian steroidogenesis resulting in decreased
secretion of estradiol and may increase androgens. although it is a
standard medicine in treating menorrhagia
According the study of Efficacy of vaginal danazol treatment in women with menorrhagia during fertile age by Luisi
S, Razzi S, Lazzeri L, Bocchi C, Severi FM, Petraglia F., researchers
concluded that vaginal danazol resulted in effective medical treatment
in young women with menorrhagia, and, because of a lack of significant
adverse effects, it may be proposed as an alternative treatment.
4. Contraceptive coil (Mirena)
a. It is a soft, flexible T-shaped (birth control) device placed
inside the uterus by your doctor within 7 days after the start of your
period with medication Mirena continuous release over a period of 5
years to prevent pregnancy and reduce symptoms of menorrhagia. According
to the study of SAFETY AND EFFICACY OF MIRENA IN MENORRHAGIA : 10 YEARS
RESULTS OF VUOKKO-STUDY by R. Hurskainen, researcher suggested The
preliminary 10-year results of Vuokko study show that LNG-IUS is a good
alternative option to hysterectomy in the treatment of menorrhagia.
Although half of the women assigned to the LNG-IUS group eventually
underwent hysterectomy, the costs remain significantly lower than in
hysterectomy group. The transition from menorrhagia to menopause seems
to be well tolerated and associated with a favourable bleeding pattern.
b. Risks and side effects
b.1.Spotting between periods
b.2. Complete absence of menstrual flow
b.3. Decreased bleeding during periods
b.4. Prolonged bleeding during periods
b.5. Breast pain and tenderness
b.6. Etc.
B.2. Non-hormonal treatments
1. Cyklokapron (tranexamic acid )
The medication has been used widely to reduce short-term in people
up to 50% with a certain type of bleeding disorder, including
menorrhagia.
2. According to the article of Cyklokapron posted in Drug.com
Risks and Side effects of Cyklokapron Injection include
a. In patients with acquired defective color vision, since this
prohibits measuring one endpoint that should be followed as a measure of
toxicity
b. In patients with subarachnoid hemorrhage. Anecdotal experience
indicates that cerebral edema and cerebral infarction may be caused by
Cyklokapron in such patients.
c. In patients with active intravascular clotting.
d. In patients with hypersensitivity to tranexamic acid or any of the ingredients.
B.3. Non-steroidal anti-inflammatory drugs (NSAIDs)
1. Non-steroidal anti-inflammatory drugs (NSAIDs) are drugs
with analgesic and antipyretic, anti-inflammatory effects, including
over counter medicine aspirin, ibuprofen, and naproxen. The medicine has
been use to reduce blood loss (it has been shown to be effective in
randomized controlled trials, reducing menstrual blood loss (MBL) by
29.0% (95% CI 27.9 to 30.2%). and menstrual cramps and pain for women
with menorrhagia)
2. Risks and side effects
a. Stomach bleeding
b. Heart failure
c. Toxicity to the kidneys, ears, and stomach
d. Heart diseases
e. Some researchers advised that Taking more than one NSAID is risky.
f. Etc.
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