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 examines medical and surgical treatments for menorrhagia in women, noting the condition can limit normal activities and cause anaemia in two-thirds of women with objective menorrhagia (loss of 80 mL blood per cycle), and may be associated with prostaglandin disorders, fibroids, adenomyosis, or intrauterine device use. It reports fibroids were found in 10% of women with menorrhagia overall and 40% of women with severe menorrhagia, while half of women undergoing hysterectomy for menorrhagia had a normal uterus. Searching Medline, Embase, and The Cochrane Library through June 2011, the authors identified 39 systematic reviews, RCTs, or observational studies and performed a GRADE evaluation of evidence quality.
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 June 2011 (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 anti-inflammatory drugs (NSAIDs), progestogens, and the following surgical interventions: dilatation and curettage, endometrial destruction, and hysterectomy.
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