Management of heavy bleeding Flashcards
Mefenamic acid and NSAID - how effective are they?
Associated with a reduction in mean menstrual blood loss of 20 - 25 %
When is Mefenamic acid and NSAID first line?
Tx of choice where heavy bleeding and dysmenorrhoea co exists
When is Mefenamic acid and NSAIDs contraindicated?
- Contraindicated with a history of
- duodenal ulcer
- asthma
How effective is Tranexamic acid?
Associated with mean reduction in menstrual blood loss of 50%
How is tranexamic acid taken?
- Only to be taken on days where bleeding is particularly heavy
- compatible with attempts of conception
Combined contraceptive pill - how effective is it?
Very effective especially as it double sup as contraception if taken properly
Contraindications of combined oral contraceptive pill
- Patients with risk factors for thromboembolism
- > 35 years and smoke
- History of breast cancer
- If overweight
Norethisterone - how effective is it
cyclical progesterone taken from day 6 to 26 of menstrual cycle
- regulates bleeding pattern
Disadvantages of prescribing Norethisterone
- Not a contraceptive and can cause breakthrough bleeding
Mirena coil - benefits
- Contraceptive cover
2. Effective for dysmenorrhoea
GnRH agonists - how do they work?
Act on the pituitary gland to stop the production of oestrogen
Benefits of GnRH agonist use
Effective for associated dysmenorrhoea
Disadvantages of GnRH agonists
- Irregular bleeding
- Menopausal symptoms - flushing and sweating
- Only suitable short term unless combined with HRT
Surgical management options
- Endometrial ablation
2. Hysterectomy