Takaisin Tulosta

Nonsteroidal anti-inflammatory drugs for heavy menstrual bleeding

Evidence summaries
Editors
Last reviewed as up-to-date 17.10.2019Latest change 17.10.2019

Level of evidence: A↑↑

NSAIDs are effective for heavy menstrual bleeding compared with placebo but are less effective than either tranexamic acid, danazol, or the levonorgestrel releasing intrauterine system.

Strong recommendation for using an intervention:

NSAIDs are recommended for patients with heavy menstrual bleeding and dysmenorrhea who do not accept or tolerate hormonal treatment and who do not have a bleeding disorder.

A Cochrane review «»1 «...»1 included 18 studies with a total of 759 subjects. As a group, NDAIDs were more effective than placebo at reducing heavy menstrual bleeding but less effective than either tranexamic acid, danazol or the levonorgestrel releasing intrauterine system. Treatment with danazol caused a shorter duration of menstruation and more adverse events than NSAIDs but this did not appear to affect the acceptability of treatment. There were no statistically significant differences between NSAIDs and the other treatmanets (oral luteal progestogens, ethamsylate, an older progesterone releasing intra-uterine system and oral contraceptive pill), although these results were based on very small studies. There was no evidence of a difference between the individual NSAIDs (naproxen and mefenamic acid).

References

  1. Bofill Rodriguez M, Lethaby A, Farquhar C. Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding. Cochrane Database Syst Rev 2019;(9):CD000400. «PMID: 31535715»PubMed