Women’s Health

Conservative General Measures:

If the bleeding due to menorrhagia is not heavy and consequent anemia is not serious or hemoglobin is normal, the patient should be observed for few months, as in many cases there is spontaneous cure (recovery from menorrhagia) and it should be awaited. If the patient’s menorrhagia is severe there is always some degree of anemia. In this juncture the complete hemogram test should be done instead of doing only hemoglobin estimation. As a conservative measure oral iron preparation should be given to the patient and response to the oral iron checked by serial blood count and hemoglobin estimation (generally at least twice a month, if possible every week). If patient is not responding to iron satisfactorily due to any cause (may be due to iron intolerance, failure to utilize the oral iron etc.), she should be given parenteral iron preparation till anemia is fully corrected and body iron stores become normal. The patient should be reassured and bed rest and sedatives given, which plays important role in conservative management of menorrhagia. If anemia is severe, blood transfusion may be required.

Role of NSAIDs in menorrhagia:

The NSAID (non steroidal anti inflammatory drug) used is mefenamic acid 500 mg three times a day with full stomach. This is given for 5-6 days during menstruation in menorrhagia cases of ovulatory cycles, menorrhagia associated with IUCD, and post sterilization menorrhagia. The common side effects of mefenamic acid are nausea, vomiting, headache, dyspepsia, hemolytic anemia etc.

Role of antifibrinolytic drugs:

The drug which was tried with varying result in menorrhagia is epsilon-amino-caproic acid at the dose of 1-3 grams four times a day for 6-7 days. The side effects that are encountered with epsilon-amino-caproic acid are nausea, vomiting, headache, intracranial thrombosis etc.

This entry was posted on Monday, November 16th, 2009 at 2:44 pm and is filed under Menstrual Disorders. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.