Heavy menstrual bleeding, also known as menorrhagia, is a condition that affects many women. It is characterized by periods that last longer than seven days, or blood loss that exceeds 80 milliliters per cycle. Heavy menstrual bleeding can have various causes, such as hormonal imbalances, uterine fibroids, polyps, adenomyosis, IUDs, pregnancy complications, or cancer. Heavy menstrual bleeding can lead to anemia, fatigue, and reduced quality of life.
A Cochrane review was conducted on different studies about the treatment and the results were:
Bottomline:
“Evidence suggests that the levonorgestrel‐releasing intrauterine system (LNG‐IUS) is the best first‐line option for reducing menstrual bleeding, while antifibrinolytics are probably the second best, and long‐cycle progestogens are the third best. Because of some limitations in the evidence, we are not sure what the true effect of these first‐line treatments is for the perception of improvement and satisfaction.
For second‐line treatments, evidence suggests any type of hysterectomy is the best treatment for reducing bleeding, even though this is a major surgery, and resectoscopic endometrial ablation (REA) and non‐resectoscopic endometrial ablation (NREA) are second and third best. We are uncertain of the true effect of the second‐line treatments on amenorrhoea (absence of menstrual blood loss). Evidence suggests that minimally invasive hysterectomy results in a large increase in satisfaction, and NREA increases satisfaction, but we are uncertain of the true effect of the remaining interventions.“
Reference:
Bofill Rodriguez M, Dias S, Jordan V, Lethaby A, Lensen SF, Wise MR, Wilkinson J, Brown J, Farquhar C. Interventions for heavy menstrual bleeding; overview of Cochrane reviews and network meta‐analysis. Cochrane Database of Systematic Reviews 2022, Issue 5. Art. No.: CD013180. DOI: 10.1002/14651858.CD013180.pub2. Accessed 08 January 2024.Acces via : https://doi.org/10.1002/14651858.CD013180.pub2
