Doctors Lounge - Gynecology Answers
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Forum Name: Gynecology
Question: Anovulation and fibroids
|Karen Militar - Fri Sep 16, 2005 1:10 am||
I'm just wondering if the treatment of anovulatory menorrhagia such as tranexamic acid and mefenamic acid, is also applicable to fibroids menorrhagia?
|Dr. Tamer Fouad - Tue Jan 10, 2006 1:53 pm||
Tranexamic acid is a synthetic derivative of the amino acid lysine. It produces an antifibrinolytic effect through the reversible blockade of lysine binding sites on plasminogen molecules. It is administered intravenously (usually 10 mg per kg followed by infusion of 1 mg per kg per hour) and has been widely used in multiple settings of blood loss, including cardiac surgery and upper gastrointestinal bleeding, resulting in a decrease in the requirement for transfusion. In the gynecologic setting, the drug has been used successfully to control bleeding in menorrhagia, placental bleeding, postpartum hemorrhage and conization of the cervix.
The first-line choices for treating anovulatory menorrhagia are tranexamic acid and nonsteroidal anti-inflammatory drugs taken during the menstrual cycle. Tranexamic acid reduces blood flow more than nonsteroidal anti-inflammatory drugs.
In the case of fibroids, tranexamic acid can be used to treat heavy periods whatever the cause. It may not be so effective if fibroids are large. However, it may be worth a try if periods are heavy and fibroids are small. In this setting tranexamic acid is taken 3-4 times a day, for 3-4 days each period. It works by reducing the breakdown of blood clots in the uterus.
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