Tranexamic acid versus Depot- Medroxyprogesterone acetate in treatment of perimenopausal irregular uterine bleeding: Randomized clinical trial

Document Type : Original Article

Authors

1 Aswan university faculty of medicine

2 gyncaecology and obestitrics faculty of medicine , aswan university hospital

3 gynacology and obstetrics , aswan unversity

4 Gynaecology and Obestritics faculty of Medicine, Aswan University hospital

Abstract

Background: Extremes ages, irregular cycles resulting from anovulation can occur. Following menarche, the immature HPO axis may result in anovulatory cycles for two to three years.
Antifibrinolytic drugs, work by preventing fibrin degradation and are effective treatments for patients with chronic AUB . Medroxyprogesterone acetate and high-dose oral progestins are used to treat AUB in women who have a contraindication to avoid estrogen in COCS treatment.
Pilot trial to compaire the efficacy of DMPA with oral medroxyprogesterone for the treatment of (AUB) by Amir et, al 2018 showed that all patients had stopped bleeding within 5 days.
Aim and objectives: compare the effectiveness of DMPA and TXA in treatment of perimenopausal irregular uterine bleeding.
Subjects and methods: RCT was conducted on Outpatient clinic , Aswan university hospital where 110 consented volunteers who were divided into two groups, 55 each, 1st group received TXA 500 mg 4times daily , and in the other received 150mg of DMPA once IM. Follow up for irregular uterine bleeding 3 months later by pictorial blood loss assessment chart (PBAC) .
Results: After one month, (PBAC) was significantly higher in group II compared to group I (0.000). After 3 months, PBAC was significantly higher in group II compared to group I (0.00). There was significant decrease in PBAC after 3 months in comparison with that after 1 month in both group I (p<0.001) and group II (p<0.001).
Conclusion: Long-term use of MPA is as effective as TXA in the treatment of perimenopausal irregular uterine bleeding.

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