Dysfunctional Uterine Bleeding Clinical Trial
Official title:
Effect of Tranexemic Acid and Norethisterone Acetate on Endometrial Vasculature in Women With Dysfunctional Uterine Bleeding.
Heavy periods is a significant problem in reproductive age .It affects about a third of women
in the childbearing period
Any of the following is considered to be heavy menstrual bleeding (Bleeding that lasts more
than 7 days,Bleeding that soaks through one or more tampons or pads every hour for several
hours in a row.Needing to wear more than one pad at a time to control menstrual flow.,Needing
to change pads or tampons during the night or Menstrual flow with blood clots that are as big
as a quarter or larger) .
Heavy periods can be caused by organic cause as fibroids, adenomyosis, polyps or they can be
dysfunctional.Dysfunctional uterine bleeding is irregular uterine bleeding that occurs in the
absence of recognisable pelvic pathology, general medical disease, or pregnancy. It reflects
a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the
endometrial lining.
Several treatment options include: hormonal treatment as norethisterone acetate,oral
contraceptive pills, gonadotrophin releasing hormone analogue. ,tranexamic acid or non
steroidal anti-inflammatory drugs.
The investigators plan to do a comparative study between norethisterone acetate and
tranexamic acid regarding their control of the heavy periods as well as their effect on the
uterine and endometrial vasculature.
This is a Randomised controlled trial.The investigators will randomise 120 women who suffer
from heavy periods (age range 35-49 years old) without organic cause (Dysfunctional bleeding
) into 2 groups, group A (60 women) : They will take norethisterone acetate 15 mg daily from
day 5 to day 26 of the period for 3 months.
Group B (60 women): They will take 1 gm tranexemic acid three times daily from the start of
menstrual period up to 5 days.The dose might be increased per day (Not more than 4 gm per
day).
The investigators will check endometrial thickness, endometrial volume, uterine artery
Doppler indices as well as endometrial and subendometrial indices before starting the
treatment and 3 months afterwards.
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