Skip to main content
SpringerLink
Log in

Benefits and Risks of Pharmacological Agents Used for the Treatment of Menorrhagia

  • Review Article
  • Published:
Drug Safety Aims and scope Submit manuscript

Abstract

Menorrhagia affects the lives of many women. The assessment of menstrual flow is highly subjective and gauging the severity of the condition by objective assessment of menstrual blood loss is impractical. In treating menorrhagia, the primary aim should be to improve quality of life. Women are willing to undergo quite invasive treatment in order to achieve this. Drug therapy is the initial treatment of choice and the only option for those who wish to preserve their reproductive function. Despite the availability of a number of drugs, there is a general lack of an evidence-based approach, marked variation in practice and continuing uncertainty regarding the most appropriate therapy. Adverse effects and problems with compliance also undermine the success of medical treatment. This article reviews the available literature to compare the efficacy and tolerability of different medical treatments for menorrhagia.

Tranexamic acid and mefenamic acid are among the most effective first-line drugs used to treat menorrhagia. Despite being used extensively in the past, oral luteal phase norethisterone is probably one of the least effective agents. Women requiring contraception have a choice of the combined oral contraceptive pill, levonorgestrel-releasing intrauterine system (LNG-IUS) or long-acting progestogens. Danazol, gestrinone and gonadotropin-releasing hormone analogues are all effective in terms of reducing menstrual blood loss but adverse effects and costs limit their long-term use. They have a role as second-line drugs for a short period of time in women awaiting surgery.

While current evidence suggests that the LNG-IUS is an effective treatment, further evaluation, including long-term follow up, is awaited. Meanwhile, the quest continues for the ideal form of medical treatment for menorrhagia — one that is effective, affordable and acceptable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Table III

Similar content being viewed by others

Notes

  1. The use of tradenames is for product identification purposes only and does not imply endorsement.

References

  1. Peto V, Coulter A, Bond A. Factors affecting general practitioners’ recruitment of patients in a prospective study. Fam Pract 1993; 10(2): 207–11

    Article  PubMed  CAS  Google Scholar 

  2. Mcpherson A, Andersson ABM, editors. Women’s problems in general practice. Oxford: Oxford University Press, 1983: 21–41

    Google Scholar 

  3. Bradlow J, Coulter A, Brooks P. Patterns of referral. Oxford: Oxford Health Services Research Unit, 1992

    Google Scholar 

  4. Shaw RW. Assessment of medical treatments of menorrhagia. Br J Obstet Gynaecol 1994; 101Suppl. 11: 15–8

    PubMed  Google Scholar 

  5. Hallberg L, Hogdahl AM, Nilsson L, et al. Menstrual blood loss: a population study. Acta Obstet Gynecol Scand 1966; 45: 320–51

    Article  PubMed  CAS  Google Scholar 

  6. Cole S, Billewicz W, Thomson A. Sources of variation in the menstrual blood loss. J Obstet Gynaecol Br Commonw 1971; 78: 933–9

    Article  PubMed  CAS  Google Scholar 

  7. Haynes P, Hodgeson H, Anderson A, et al. Measurement of menstrual blood loss in patients complaining of menorrhagia. Br J Obstet Gynaecol 1977; 84: 763–8

    Article  PubMed  CAS  Google Scholar 

  8. Market and Research International (MORI.) Women’s health in 1990. Market Opinion and Research International, 1990. (Research study conducted on behalf of Parke-Davis Laboratories)

  9. Cameron IT. Menstrual disorders. In: Edmonds DK, editor. Dewhursts textbook of obstetrics and gynaecology. 6th ed. Boston: Blackwell Science, 1999: 410–419

  10. Coulter A, Peto V, Jenkinson C. Quality of life and patient satisfaction following treatment of menorrhagia. Fam Pract 1994; 11: 394–401

    Article  PubMed  CAS  Google Scholar 

  11. Coulter A, Bradlow J, Agass M, et al. Outcome of referrals to gynaecology outpatients clinics for menstrual problems: an audit of general practice records. Br J Obstet Gynaecol 1991; 98: 789–96

    Article  PubMed  CAS  Google Scholar 

  12. Gath D, Cooper P, Day A. Hysterectomy and psychiatric disorder: 1. Levels of psychiatric morbidity before and after hysterectomy. Br J Psychiatry 1982; 140: 335–40

    Article  PubMed  CAS  Google Scholar 

  13. Clarke A, Black N, Rowe P, et al. Indications for and outcome of total abdominal hysterectomy for benign disease; a prospective cohort study. Br J Obstet Gynaecol 1995; 102: 611–20

    Article  PubMed  CAS  Google Scholar 

  14. Cooper KG, Jack SA, Parkin DE, et al. Five-year follow up of women randomised to medical management or transcervical resection of endometrium for heavy menstrual loss. Br J Obstet Gynaecol 2001; 108: 1222–8

    Article  CAS  Google Scholar 

  15. Prentice A. Medical management of menorrhagia. BMJ 1999; 319: 1343–5

    Article  PubMed  CAS  Google Scholar 

  16. Coulter A, Kelland J, Peto V, et al. Treating menorrhagia in primary care: an overview of drug trials and survey of prescribing practice. Int J Technol Assess Health Care 1995; 11: 456–71

    Article  PubMed  CAS  Google Scholar 

  17. Lethaby A, Farquhar C, Cook I. Antifibrinolytics for heavy menstrual bleeding. Cochrane Systematic Review. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue. Oxford: Update Software, 2000

    Google Scholar 

  18. Rees MCP, DiMarzo V, Tippins JR, et al. Leukotreine release by endometrium and myometrium throughout the menstrual cycle in dysmenorrhoea and menorrhagia. J Endocrinol 1987; 113: 291–5

    Article  PubMed  CAS  Google Scholar 

  19. Rees MCP, Canete-Solar R, Lopez Bernal A, et al. Effects of fenamates on prostaglandin E receptor binding. Lancet 1988; II: 541–2

    Article  Google Scholar 

  20. Cameron IT. Medical management of menorrhagia. Curr Opin Obstet Gynecol 1992; 2: 136–40

    Google Scholar 

  21. Anderson ABM, Hynes PJ, Guillebaud J, et al. Reduction of menstrual blood loss by prostaglandin synthetase inhibitors. Lancet 1976: 21: 774–6

    Article  Google Scholar 

  22. Fraser IS, Pearse C, Shearman RP, et al. Efficacy of mefenamic acid in patients with a complaint of menorrhagia. Obstet Gynecol 1981; 58: 543–51

    PubMed  CAS  Google Scholar 

  23. Fraser IS, McCarron G, Markham R, et al. Measured menstrual blood loss in women with menorrhagia associated with pelvic disease and coagulation disorder. Obstet Gynecol 1986; 68: 630–3

    PubMed  CAS  Google Scholar 

  24. Fraser IS, McCarron G, Markham R, et al. Longterm treatment of menorrhagia with mefenamic acid. Obstet Gynecol 1983; 61: 109–12

    PubMed  CAS  Google Scholar 

  25. Higham J, Shaw R. Risk-benefit assessment of drugs used for the treatment of menstrual disorders. Drug Saf 1991; 6(3): 183–91

    Article  PubMed  CAS  Google Scholar 

  26. Fraser IS. Treatment of ovulatory and anovulatory dysfunctional uterine bleeding with oral progestogens. Aust N Z J Obstet Gynaecol 1990; 30: 353–6

    Article  PubMed  CAS  Google Scholar 

  27. Stewart A, Cummins C, Gold L, et al. The effectiveness of levonorgestrel releasing intrauterine system in menorrhagia: a systematic review. Br J Obstet Gynaecol 2001; 108: 74–6

    Article  CAS  Google Scholar 

  28. Lethaby AE, Cooke I, Rees M. Progesterone/progestogen releasing intrauterine systems versus either placebo or any other medication for heavy menstrual bleeding. Cochrane systematic review. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue. Oxford: Update Software, 1999

    Google Scholar 

  29. Bhatena RK. Long acting progestogen-only contraceptive injections: an update. Br J Obstet Gynaecol 2001; 108: 3–8

    Article  Google Scholar 

  30. Fraser IS, McCarron G. Randomised trial of 2 hormonal and 2 prostaglandin-inhibiting agents in women with complaints of menorrhagia. Aust N Z J Obstet Gynaecol 1991; 31: 66–70

    Article  PubMed  CAS  Google Scholar 

  31. Khastgir G, Studd J. Choice of treatment for menorrhagia. In: Seth S, Sutton C, editors. Menorrhagia. Oxford: Isis Medical Media, 1999: 299–315

  32. Lethaby A, Augood C, Duckitt K. Nonsteroidal anti-inflammatory drugs for heavy menstrual bleeding. Cochrane Systematic Review. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue. Oxford: Update Software, 1998

    Google Scholar 

  33. Chamberlain G, Freeman R, Price F, et al. A comparative study of ethamsylate and mefenamic acid in dysfunctional uterine bleeding. Br J Obstet Gynaecol 1991; 98: 707–11

    Article  PubMed  CAS  Google Scholar 

  34. Cameron IT, Haining R, Lumsden MA, et al. The effects of mefenamic acid and norethisterone on measured menstrual blood loss. Obstet Gynecol 1990; 76: 85–8

    PubMed  CAS  Google Scholar 

  35. Cameron IT, Leask R, Kelly RW, et al. Effects of danazol, mefenamic acid, norethisterone and a progesterone-impregnated coil on endometrial prostaglandin concentrations in women with menorrhagia. Prostaglandins 1987; 34: 99–110

    Article  PubMed  CAS  Google Scholar 

  36. Dockeray CJ, Sheppard BL, Bonnar J. Comparison between mefenamic acid and danazol in the treatment of established menorrhagia. Br J Obstet Gynaecol 1989; 96: 840–4

    Article  PubMed  CAS  Google Scholar 

  37. Grover V, Usha R, Gupta U, et al. Management of cyclical menorrhagia with prostaglandin synthetase inhibitor. Asia Oceania J Obstet Gynaecol 1990; 16: 255–9

    Article  PubMed  CAS  Google Scholar 

  38. Hall P, Maclachlan N, Thorn N, et al. Control of menorrhagia by the cyclo-oxygenase inhibitors naproxen sodium and mefenamic acid. Br J Obstet Gynaecol 1987; 94: 554–8

    Article  PubMed  CAS  Google Scholar 

  39. Bonnar J, Sheppard B. Treatment of menorrhagia during menstruation: randomised controlled trial of ethamsylate, mefenamic acid and tranexamic acid. BMJ 1996; 313: 579–82

    Article  PubMed  CAS  Google Scholar 

  40. Edlund M, Anderson K, Rybo G, et al. Reduction of menstrual blood loss in women suffering from idiopathic menorrhagia with a novel antifibrinolytic drug (Kabi 2161). Br J Obstet Gynaecol 1995; 102: 913–7

    Article  PubMed  CAS  Google Scholar 

  41. Callender ST, Warner GT, Cope E. Treatment of menorrhagia with tranexamic acid: a double blind trial. BMJ 1970; 4: 214–6

    Article  PubMed  CAS  Google Scholar 

  42. Preston JT, Cameron IT, Adams EJ, et al. Comparative study of tranexamic acid and norethisterone in the treatment of ovulatory menorrhagia. Br J Obstet Gynaecol 1995; 102: 401–5

    Article  PubMed  CAS  Google Scholar 

  43. Lethaby A, Irvine G, Cameron I. Cyclical progestogens for heavy menstrual bleeding. Cochrane systematic review. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue. Oxford: Update Software, 1998

    Google Scholar 

  44. Milsom I, Anderson K, Andersch B, et al. A comparison of flurbiprofen, tranexamic acid and a levonorgestrel-releasing intrauterine contraceptive device in the treatment of idiopathic menorhagia. Am J Obstet Gynecol 1991; 164: 879–83

    PubMed  CAS  Google Scholar 

  45. Irvine GA, Campbell-Brown MB, Lumsden MA, et al. Randomised comparative trial of the levonorgestrel intrauterine system and norethisterone for treatment of idiopathic menorrhagia. Br J Obstet Gynaecol 1998; 105(6): 592–8

    Article  PubMed  CAS  Google Scholar 

  46. Crosignani PG, Vercellini P, Mosconi P, et al. Levonorgestrel releasing intrauterine device versus hysteroscopic endometrial resection in treatment of dysfunctional uterine bleeding. Obstet Gynecol 1997; 90: 257–63

    Article  PubMed  CAS  Google Scholar 

  47. Kittleson N, Istre O. A randomised study comparing Levonorgestrel intrauterine system (LNG IUS) and transcervical resection of endometrium (TCRE) in the treatment of menorrhagia: preliminary results. Gynecol Endocrinol 1998; 7: 61–5

    Google Scholar 

  48. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. London 2002 Mar; 43: 475–6

  49. Andersch B, Milsom I, Rybo G. An objective evaluation of flurbiprofen and tranexamic acid in the treatment of idiopathic menorrhagia. Acta Obstet Gynecol Scand 1988; 67: 645–8

    Article  PubMed  CAS  Google Scholar 

  50. Effective Health Care. The management of menorrhagia. NHS Centre for Reviews and Dissemination, University of York, Research Unit, Royal College of Physicians 1995 (1)

  51. Rybo G. Tranexamic acid therapy effective treatment in heavy menstrual bleeding: clinical update. Thera Adv 1991; 4: 1–8

    Google Scholar 

  52. Royal College of Obstetricians and Gynaecologists. The initial management of menorrhagia: RCOG evidence based clinical guidelines No. 1. London, 1998

  53. Fender GRK, Prentice A, Gorst T, et al. Randomised controlled trial of educational package on management of menorrhagia in primary care: the Anglia Menorrhagia Education Study. BMJ 1999; 318: 1246–50

    Article  PubMed  CAS  Google Scholar 

  54. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. London 2002 Mar; 43: 123

  55. Kovacs L, Falkay G. Ethamsylate as inhibitor of prostaglandin biosynthesys in pregnant human myometrium in-vitro. Experientia 1981; 37: 1182–3

    Article  PubMed  CAS  Google Scholar 

  56. Rennie JM, Lam PKL. Effects of ethamsylate on cerebral blood flow velocity in premature babies. Arch Dis Child 1989; 64: 46–7

    Article  PubMed  CAS  Google Scholar 

  57. Jaffe G, Wickham A. A double blind pilot study of dicynene in the control of menorrhagia. J Int Med Res 1973; 1: 127–9

    Google Scholar 

  58. Harrison RF, Campbell S. A double blind trial of ethamsylate in the treatment of primary and intra-uterine device menorrhagia. Lancet 1976; II: 283–5

    Article  Google Scholar 

  59. Hickey M, Higham J, Fraser IS. Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation. Cochrane Systematic Review. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue. Oxford: Update Software, 1998

    Google Scholar 

  60. Bonduelle M, Walker JJ, Calder AA. A comparative study of danazol and norethisterone in dysfunctional uterine bleeding presenting as menorrhagia. Postgrad Med J 1991; 67: 833–6

    Article  PubMed  CAS  Google Scholar 

  61. Buyru F, Yalcin O, Kovanci E, et al. Danazol therapy in dysfunctional uterine bleeding [Turkish]. Istanbul Universitesi Tip Fakultesi Mecmuasi 1995; 58(3): 37–40

    Google Scholar 

  62. Higham JM, Shaw RW. A comparative study of danazol, a regimen of decreasing doses of danazol, and norethindrone in the treatment of objectively proven unexplained menorrhagia. Am J Obstet Gynecol 1993; 169: 1134–9

    PubMed  CAS  Google Scholar 

  63. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. London 2002 Mar; 43: 356

  64. Bergqvist A, Rybo G. Treatment of menorrhagia with intrauterine release of progesterone. Br J Obstet Gynaecol 1983; 90: 255–8

    Article  PubMed  CAS  Google Scholar 

  65. Van den Hurk PJ, O’Brien PMS. Non-contraceptive use of levonorgestrel-releasing intrauterine system. Obstet Gynecol 1999; 1(1): 13–9

    Article  Google Scholar 

  66. Backman T, Huhtala S, Blom T, et al. Length and use of symptoms associated with premature removal of the levonorgestrel instruterine system: a nation-wide study of 17,360 users. BJOG. 2000; 107: 335–9

    Article  PubMed  CAS  Google Scholar 

  67. Lahteenmaki P, Haukkamaa M, Puolakka J, et al. Open randomised study of use of levonorgestrel releasing intrauterine system as alternative to hysterectomy. BMJ 1998; 316: 1122–6

    Article  PubMed  CAS  Google Scholar 

  68. Barrington JW, Bowen-Simpkins P. The levonorgestrel intrauterine system in the management of menorrhagia. Br J Obstet Gynaecol 1997; 104: 614–6

    Article  PubMed  CAS  Google Scholar 

  69. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. London 2002; 43 Mar: 393–394

  70. Hurskainen R, Teperi J, Rissanen P, et al. Quality of life and cost-effectiveness of levonorgestrel-releasing intrauterine system versus hysterectomy for treatment of menorrhagia: a randomised trial: early report. Lancet 2001; 357: 273–7

    Article  PubMed  CAS  Google Scholar 

  71. EuroQol Group. EuroQol: a new facility for the treatment of health-related quality of life. Health Policy 1990; 16: 199–208

    Google Scholar 

  72. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. London 2002 Mar; 43: 357

  73. Working party on behalf of the National Health Committee. Guidelines for management of heavy menstrual bleeding. Wellington: National Health Committee, 1998

  74. Nagrani R, Bowen-Simpkins P, Barrington JW. Can levonorgestrel intrauterine system replace surgical treatment for the management of menorrhagia? Br J Obstet Gynaecol 2002; 109: 345–7

    Article  Google Scholar 

  75. The Royal College of Obstetricians and Gynaecologists. The management of menorrhagia in secondary care. National evidence-based clinical guidelines. RCOG, 1999

  76. Belsey EM. Vaginal bleeding patterns among women using one natural and eight hormonal methods of contraception. Contraception 1988; 38: 181–206

    Article  PubMed  CAS  Google Scholar 

  77. Schwallie PC, Assenzo JR. Contraceptive use-efficacy study using depo-provera administered as an injection every 90 days. Fertil Steril 1973; 24: 331–42

    PubMed  CAS  Google Scholar 

  78. Fraser IS. A survey of different approaches to management of menstrual disturbances in women using injectable contraceptives. Contraception 1983; 28: 385–97

    Article  PubMed  CAS  Google Scholar 

  79. Rowlands S, Dakin L. Twelve years of injectable contraceptive use in general practice. Br J Fam Plann 1998; 23: 133–4

    PubMed  CAS  Google Scholar 

  80. Paul C, Skegg DC, Williams S. Depot medroxyprogesterone acetate: patterns of use and reasons for discontinuation. Contraception 1997; 56(4): 209–14

    Article  PubMed  CAS  Google Scholar 

  81. World Health Organisation. A multicentered phase III comparative clinical trial of depot-medroxyprogesterone acetate given three monthly at doses of 100mg or 150mg: contraceptive efficacy and side effects [abstract]. Contraception 1986; 34: 223

    Google Scholar 

  82. World Health Organisation. Multinational comparative evaluation of two long acting contraceptive steroids: norethisterone enanthate and medroxyprogesterone acetate: final report [abstract]. Contraception 1983; 28: 1

    Google Scholar 

  83. Cromer BA, Smith RD, Blair JM, et al. A prospective study of adolescents who chose among levonorgestrel implant, medroxy-progesterone acetate or the combined oral contraceptive pill as contraception. Pediatrics 1994; 94: 687–94

    PubMed  CAS  Google Scholar 

  84. Amataykul K, Siarasonboon B, Thanangkul O. A study of mechanism of weight gain in medroxyprogesterone users. Contraception 1980; 22: 605–22

    Article  Google Scholar 

  85. Matson SC, Henderson KA, McGrath GJ. Physical findings and symptoms of depot-medroxyprogesterone acetate use in adolescent females. J Pediatr Adolesc Gynecol 1997; 10: 18–23

    Article  PubMed  CAS  Google Scholar 

  86. Cundy T, Evans M, Roberts H, et al. Bone density in women receiving depot medroxy progesterone for contraception. BMJ 1991; 303: 13–6

    Article  PubMed  CAS  Google Scholar 

  87. Guillebaud J. Oestrogen free hormonal contraception. In: Guillebaud J, editor. Contraceptions: your questions answered. Edinburgh: Churchill Livingstone, 1999: 311–6, 328-9

    Google Scholar 

  88. Mishell Jr DR. Noncontraceptive health benefits of oral steroidal contraceptives. Am J Obstet Gynecol 1982; 142: 809–16

    PubMed  Google Scholar 

  89. Iyer V, Farquhar C, Jepson R. Oral contraceptive pills for heavy menstrual bleeding. Cochrane Systematic Review. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; Issue 2. Oxford: Update Software, 1997

    Google Scholar 

  90. Nilsson L, Solvell L. Clinical studies in oral contraceptives: a randomised double blind crossover study of 4 different preparations. Acta Obstet Gynecol Scand 1967; 46Suppl. 8: 1–31

    PubMed  Google Scholar 

  91. Nilsson L, Rybo G. Treatment of menorrhagia. Am J Obstet Gynecol 1971; 110: 713–20

    PubMed  CAS  Google Scholar 

  92. Hefnawi F, Askalani H, Zaki K. Menstrual blood loss with copper intrauterine devices. Contraception 1974; 9: 133–9

    Article  PubMed  CAS  Google Scholar 

  93. Callard GV, Litofswky FS, De Merre LJ. Menstruation in women with normal or artificially controlled cycles. Fertil Steril 1966; 17: 684–8

    PubMed  CAS  Google Scholar 

  94. Royal College of General Practitioners. Oral contraceptive and health. London: Pitman Medical, 1974

  95. Ramacharan S, Pelligrin FA, Ray MR, et al. The Walnut Creek Contraceptive Drug Study: a prospective study of the side effects of oral contraceptives. Volume III. An interim report: a comparison of disease occurrence leading to hospitalisation or death in users or non users of oral contraceptives. J Reprod Med 1980; 25Suppl. 6: 345–72

    Google Scholar 

  96. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. London 2002 Mar; 43: 386–9

  97. Gray RH. Patterns of bleeding associated with the use of steroidal contraceptives. In: Diczfalusy E, Fraser IS, Webb FTG, editors. Endometrial bleeding and steroidal contraception. Bath: Pitman Press, 1980: 14–49

    Google Scholar 

  98. Speroff L, Glass RH, Case N. Endometriosis. In: Speroff L, Glass RH, Case N, editors. Clinical gynaecologic endocrinology and infertility. 6th ed. Baltimore: Lippincot Williams & Wilkins, 1999: 1064

    Google Scholar 

  99. Barbieri RL, Osathanondh R, Ryan KJ. Danazol inhibition of steroidogenesis in human corpus luteum. Obstet Gynecol 1981; 57: 722–4

    PubMed  CAS  Google Scholar 

  100. Need JA, Forbes KL, Millazzo L, et al. Danazol in the treatment of menorrhagia: the effect of 1 month induction dose (200mg) and 2 months of maintenance therapy (200mg, 100mg, 50mg or placebo). Aust N Z J Obstet Gynaecol 1992; 32: 346–52

    Article  PubMed  CAS  Google Scholar 

  101. Chimbira TH, Anderson AB, Naish C, et al. Reduction of menstrual blood loss by danazol in menorrhagia: lack of effect of placebo. Br J Obstet Gynaecol 1980; 87: 1152–8

    Article  PubMed  CAS  Google Scholar 

  102. Chimbira TH, Cope E, Anderson AB, et al. The effect of danazol on menorrhagia, coagulation mechanism, haematological indices and body weight. Br J Obstet Gynaecol 1979; 86: 46–50

    Article  PubMed  CAS  Google Scholar 

  103. Beaumont H, Augood C, Duckitt K. Danazol for heavy menstrual bleeding. Cochrane systematic review. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue. Oxford: Update Software, 2002

    Google Scholar 

  104. Lamb MP Danazol in menorrhagia: a double blind placebo controlled trial. J Obstet Gynaecol 1987; 7: 212–6

    Google Scholar 

  105. Wardle PG, Whitehead MI, Mills RP. Nonreversible and wide ranging vocal changes after treatment with danazol [abstract]. BMJ 1983; 287: 946

    Article  PubMed  CAS  Google Scholar 

  106. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. London 2002 Mar; 43: 372

  107. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. London 2002 Mar; 43: 373

  108. Turnbull AC, Rees MC. Gestrinone in the treatment of menorrhagia. Br J Obstet Gynaecol 1990; 97: 713–5

    Article  PubMed  CAS  Google Scholar 

  109. Shaw RW, Duckitt K. Management of menorrhagia in women of childbearing age. In: Seth S, Sutton C, editors. Menorrhagia. Oxford: Isis Medical Media, 1999: 79–96

    Google Scholar 

  110. Shaw RW, Fraser HM. Use of superactive LHRH agonist in the treatment of menorrhagia. Br J Obstet Gynaecol 1984; 91: 913–6

    Article  PubMed  CAS  Google Scholar 

  111. Miller RM, Frank RA. Zoladex in the treatment of benign gynaecological disorder: an overview of safety and efficacy. Br J Obstet Gynaecol 1992; 99Suppl. 7: 37–41

    PubMed  Google Scholar 

  112. Thomas EJ, Okuda KJ, Thomas NM. Combination of GNRH agonist and cyclical HRT for DUB. Br J Obstet Gynaecol 1991; 98: 1155–9

    Article  PubMed  CAS  Google Scholar 

  113. Lilford RJ. Hysterectomy: will it pay the bills in 2007 [editorial]. BMJ 1997; 314: 160–1

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank Lynn Garden and Liz Grant for secretarial assistance. No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflict of interest that are directly relevant to the content of this manuscript.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom

    Samendra Nath Roy & Siladitya Bhattacharya

Authors
  1. Samendra Nath Roy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Siladitya Bhattacharya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Samendra Nath Roy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roy, S.N., Bhattacharya, S. Benefits and Risks of Pharmacological Agents Used for the Treatment of Menorrhagia. Drug-Safety 27, 75–90 (2004). https://doi.org/10.2165/00002018-200427020-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002018-200427020-00001

Keywords

Search

Navigation