Randomised trial of mefenamic acid versus tranexamic acid in management of menorrhagia


  • Madhu J. Department of Obstetrics and Gynecology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
  • Shylaja A. S. Department of Obstetrics and Gynecology, St. Philomena’s Hospital, Viveknagar, Bengaluru, Karnataka, India




Menorrhagia, Mefenamic acid, Pictoral blood loss assessment chart, Tranexamic acid


Background: The objective of the study was to compare the efficacy of mefenamic acid, a non-inflammatory drug with tranexamic acid, an antifibrinolytic drug in management of menorrhaghia.

Methods: Randomised trial of women attending outpatient department of St. Philomena’s hospital, Bangalore with complaints of menorrhagia. Fifty four patients with complaints of menorrhagia were randomly assigned to receive either mefenamic acid 500 mg tid (group A- 24 patients) or tranexamic acid 1 gm TID (group B- 26 patients) from day one to day five for three consecutive menstrual cycles.

Results: Reduction in menstrual blood loss as assessed by pictoral blood loss assessment chart was more in group B (50%) than in Group A (30%) (ANOVA, covariates with F=59.647, p<0.001). Difference in improvement of dysmenorrhoea was not statistically significant (p=0.640). Side effects were less in group B compared to group A (p=0.271). Post treatment Hb% significantly improved in both groups (p=0.015 in group A, p<0.001 in gr B). Acceptability was statistically similar in both groups (p>0.05).

Conclusions: Both mefenamic acid and tranexamic acid were effective in management of menorrhagia. Tranexamic acid was significantly superior to mefenamic acid in terms of reduction in menstrual blood loss.


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