Comparison of Traneximic Acid with a Combination of Traneximic Acid and Mefenamic Acid in Reducing Menstrual Blood Loss in Ovulatory Dysfunctional Uterine Bleeding (DUB) 3020-3025
Dr. Rehana Najam
Department of Obstetrics and Gynecology
Teerthanker Mahaveer Medical College, Bagarpur, Delhi Road,
Moradabad, U.P. (India)
E mail: firstname.lastname@example.org
Objective: To compare the efficacy of traneximic acid (Txa), with a combination of traneximic acid (Txa) and mefenamic acid (Mfa) in reducing menstrual blood loss in patients of ovulatory DUB.
Design: Prospective, randomised trial performed in 110 patients of ovulatory dysfunctional uterine bleeding.
Intervention: Patients diagnosed with ovuatory DUB based on the history of regular heavy cyclical bleeding, with normal transvaginal sonography (n= 110 patients), were included in the study. The patients were grouped into two, group T receiving tablets of 500mg Txa, three times a day from day 1 to 5 of the menstrual cycle, and group TM receiving tablets of 500mg Txa +250mg Mfa, three times a day from day 1 to 5 of the menstrual cycle, for 3 cycles i.e. 3 months. The efficacy of the treatment in both the groups was evaluated by recording the reduction in menstrual blood loss (measured by calculating pictorial blood assessment chart scores) and the improvement in post-treatment haemoglobin concentrations at 3 and 6 months follow up.
Results: Of the 110 patients who were followed up for a period of 6 months, 38.1% (n=42) were in the age group of 30-39 years. 54.5% of the patients (n=60) presented with moderate anaemia at the first outpatient visit. In the T group, the mean pre-treatment haemoglobin concentration was 9.5 g/dl and the mean PBAC score was 250. At 6 months of follow up, the mean haemoglobin concentration was 12.0 g/dl, which showed an improvement by 26.3% and the mean PBAC score was 125, which showed an improvement by 50%. In group TM, the mean pre-treatment haemoglobin concentration and the PBAC score were 8.6 g/dl and 246, respectively, while at 6 months of follow up, the mean haemoglobin concentration was 12.3g/dl, which showed an improvement of 38.9% and the PBAC score was 100, with a decline of 59.3%.
Conclusion: Both traneximic acid and a combination of traneximic acid and mefenamic acid are effective in decreasing PBAC scores and reducing menstrual blood loss in DUB, though a combination of traneximic acid and mefenamic acid showed better long term results.