Study summary · research use only
Menorrhagia
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This systematic review examined treatments for menorrhagia in women. The authors state that menorrhagia limits normal activities and causes anaemia in two thirds of women with objective menorrhagia (loss of 80 mL blood per cycle), that fibroids were found in 10% of women with menorrhagia overall and 40% with severe menorrhagia, and that half of women having a hysterectomy for menorrhagia are found to have a normal uterus. They searched Medline, Embase, The Cochrane Library, and other databases up to October 2007 and included harms alerts from the FDA and MHRA. They found 39 systematic reviews, RCTs, or observational studies meeting inclusion criteria. The review presents information on medical interventions (combined pill, danazol, etamsylate, gonadorelin analogues, intrauterine progesterone, NSAIDs, progestogens) and surgical interventions (dilatation and curettage, endometrial destruction, hysterectomy).
Abstract
Menorrhagia limits normal activities, and causes anaemia in two thirds of women with objective menorrhagia (loss of 80 mL blood per cycle). Prostaglandin disorders may be associated with idiopathic menorrhagia, and with heavy bleeding due to fibroids, adenomyosis, or use of intrauterine devices (IUDs). Fibroids have been found in 10% of women with menorrhagia overall, and in 40% of women with severe menorrhagia; but half of women having a hysterectomy for menorrhagia are found to have a normal uterus. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical treatments for menorrhagia? What are the effects of surgical treatments for menorrhagia? What are the effects of endometrial thinning before endometrial destruction in treating menorrhagia? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 39 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following medical interventions: combined pill, danazol, etamsylate, gonadorelin analogues, intrauterine progesterone, non-steroidal inflammatory drugs (NSAIDs), progestogens, and the following surgical interventions: dilatation and curretage, endometrial destruction, and hysterectomy.
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