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Evidence summaries

Danazol for Heavy Menstrual Bleeding

Danazol appears to be an effective treatment for heavy menstrual bleeding compared to other medical treatments, but its use is restricted by side effects and limited acceptability. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 9 studies with a total of 353 subjects. Danazol appeared to be more effective than placebo, progestogens, NSAIDs and the OCP at reducing menstrual blood loss, but confidence intervals were wide. Treatment with danazol caused more adverse events than NSAIDs (OR 7.0; 95% CI 1.7, 28.2) and progestogens (OR 4.05, 95% CI 1.6, 10.2), but this did not appear to affect adherence to treatment. Danazol was shown to significantly lower the duration of menses when compared with NSAIDs (WMD -1.0; 95% CI -1.8 to -0.3) and a progesterone-releasing IUD (WMD -6.0; 95% CI -7.3 to -4.8). There were no randomised trials comparing danazol with tranexamic acid or the levonorgestrel-releasing intrauterine system.

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).

    References

    • Beaumont H, Augood C, Duckitt K, Lethaby A. Danazol for heavy menstrual bleeding. Cochrane Database Syst Rev 2007 Jul 18;(3):CD001017. [PubMed]

Primary/Secondary Keywords