Diosmin versus tranexamic acid in heavy menstrual bleeding: a randomized controlled trial

Authors

  • Vinita Gupta Department of Obstetrics and Gynaecology, Medical College Kolkata, Kolkata, West Bengal, India
  • Anirban Das Department of Obstetrics and Gynaecology, Medical College Kolkata, Kolkata, West Bengal, India
  • Sujata Dalai Department of Anaesthesiology, Raiganj Government Medical College, Raiganj, West Bengal, India
  • Pallab Kumar Mistri Department of Obstetrics and Gynaecology, Medical College Kolkata, Kolkata, West Bengal, India http://orcid.org/0000-0003-1976-3879

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20223125

Keywords:

Diosmin, Tranexamic acid, HMB, Menorrhagia

Abstract

Background: Heavy menstrual bleeding (HMB) is defined as cyclical bleeding at regular intervals but excessive in amount which affect the physical, social and mental aspects of life of a woman. The prevalence is 10-30% in reproductive age women and 50% in perimenopausal women. HMB is not just a clinical burden but also a huge social and economic burden. The aims and objective of my study is to compare the efficacy of diosmin and tranexamic acid in acute HMB in terms of average duration of menstrual cycle, PBAC/PABC score, endometrial thickness, hemoglobin concentration and finally need for other modes of treatment.

Methods: The study was a randomized control trial in which the patients (sample size-72) were divided into two groups- group D (n=36) and group T (n=36). Group D was treated with tab diosmin 500 mg thrice daily from day 1 to day 5 of menstrual cycle. Similarly group T was treated with tab tranexamic acid 500 mg thrice daily from day 1 to day 5 of menstrual cycle. The PBAC score was taken at the end of three months along with endometrial thickness and hemoglobin concentration. The results were compared with values obtained before initiating treatment.

Results: In this study after 3 months of treatment; the patients in group D had an initial PBAC score of 423.52 and at the end of treatment it was decreased to 149.89 (p<0.0001). Reduction was 60.5%. Group T patients had an initial PBAC score of 441which was reduced to 177.94 (p<0.0001) after treatment. The reduction in this group was 59.6%.

Conclusions: In this study it was found that both tranexamic acid and diosmin were effective in reduction of HMB, in terms of PBAC score, average duration of menstrual cycle and endometrial thickness. But the in reduction in PBAC score was similar in both the groups. The failure rates were also similar in both the groups, but improvements in hemoglobin concentration were only marginal

Author Biographies

Vinita Gupta, Department of Obstetrics and Gynaecology, Medical College Kolkata, Kolkata, West Bengal, India

SENIOR RESIDENT, DEPT. OF OBS AND GYNAE, MEDICAL COLLEGE KOLKATA, 88 COLLEGE STREET, KOLKATA- 73, WEST BENGAL, INDIA

Anirban Das, Department of Obstetrics and Gynaecology, Medical College Kolkata, Kolkata, West Bengal, India

SENIOR RESIDENT, DEPT. OF OBSTETRICS & GYNAECOLOGY, MEDICAL COLLEGE KOLKATA, WEST BENGAL, INDIA

Sujata Dalai, Department of Anaesthesiology, Raiganj Government Medical College, Raiganj, West Bengal, India

ASSOCIATE PROFESSOR, DEPT. OF ANESTHESIOLOGY, RAIGANJ GOVERNMENT MEDICAL COLLEGE, RAIGANJ, WEST BENGAL, INDIA, CONTACT NO. 09007854446, EMAIL: sujata1510@gmail.com

Pallab Kumar Mistri, Department of Obstetrics and Gynaecology, Medical College Kolkata, Kolkata, West Bengal, India

ASSOCIATE PROFESSOR, DEPT. OF OBSTETRICS AND GYNAECOLOGY, MEDICAL COLLEGE KOLKATA, 88 COLLEGE STREET, KOLKATA, WEST BENGAL, INDIA, CONTACT NO. 8240143426, EMAIL: pallab1012@gmail.com

References

Speroff F. Speroff’s clinical gynecologic endocrinology and infertility. Wolters Kluwer, eighth edition. 2011;592.

Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health. 2007;10(3):183-94.

Dewhurst J. Dysfunctional uterine bleeding. Obstetrics and gynecology for postgraduates. Blackwell Scientific Publishers. 2011;565-91.

Lyseng-Williamson KA, Perry CM. Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids. Drugs. 2003;63:71-100.

Cyklokapron. e-CPS (online version of Compendium of Pharmaceuticals and Specialties). 2009.

Wellington K, Wagstaff AJ. Tranexamic acid: a review of its use in the management of menorrhagia. Drugs. 2003;63(13):1417-33.

Leminen H, Hurskainen R. Tranexamic acid for the treatment of heavy menstrual bleeding: efficacy and safety. Int J Womens Health. 2012;4:413-21.

Kiseli M, Kayikcioglu F, Evliyaoglu O, Haberal A. Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study. Gynecol Obstet Invest. 2016;81(5):447-53.

Alanwar, Abbas AM, Hussain SH, Elhawwary, Mansour DY, Faisal MM, Elshabrawy A. Oral micronised flavonoids versus tranexamic acid for treatment of heavy menstrual bleeding secondary to copper IUD use: a randomised double-blind clinical trial. Eur J Contracept Reprod Health Care. 2018;23(5):365370.

Mukherjee GG, Gajaraj AJ, Mathias J, Marya D. Treatment of abnormal uterine bleeding with micronized flavonoids. Int J Gynaecol Obstet. 2005;89(2):156-7.

Bahman M, Mirahi A, Hajimehdipoor H, Tansaz M. The effect of quince paste on menorrhagia: a clinical study. Int J Pharm Sci Res. 2018;9(4):1654-59.

Downloads

Published

2022-11-25

Issue

Section

Original Research Articles