Non-Surgical Interventions for Treating Heavy Menstrual Bleeding (Menorrhagia) in Women with Bleeding Disorders

Summary

A Cochrane review [Abstract] 1 included 3 cross-over studies with a total of 175 subjects. In two studies (n = 59) comparing desmopressin with placebo no clear difference between groups was found. The first of these reported a mean difference in menstrual blood loss in the desmopressin vs placebo group of 21.20 mL (95% confidence interval -19.00 to 61.50). In the second study there was no clear evidence of difference in pictorial bleeding assessment chart scores (PBAC). The third study comparing desmopressin with tranexamic acid (n = 116) found a decrease in PBAC after both treatments as compared to baseline. The decrease in these scores was greater for tranexamic acid than for desmopressin, with a mean difference of 41.6 mL (95% CI 19.6 to 63; P < 0.0002). In relation to adverse events, there was no clear difference when placebo was compared to desmopressin, or when desmopressin was compared to tranexamic acid.