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Reproductive Physiology, Endocrinology, and Infertility

Question
48 out of 56
 

Evidence-based treatments for menorrhagia are all except: (AIPG 2011)



A OCPs

B Progesterone for three months cyclically

C Tranexamic acid

D Ethamsylate

Ans. D

Ethamsylate

Menorrhagia is defined as total blood loss exceeding 80 mL per cycle or menses lasting longer than 7 days. Menorrhagia is present in almost 30% of all premenopausal women

1. Treatment consists of

Nonsteroidal anti-inflammatory drugs, which arealso the first-line medical therapy in ovulatory menorrhagia. an average reduction of 25-35% in menstrual blood flow is seen.

Oral contraceptive pills: Menstrual blood loss is reduced as much as 60% due to endometrial atrophy.

2. Progestin therapy This therapy with progestin results in a 15% reduction in menstrual blood flow.

Gonadotropin-releasing hormone agonists: GnRH agonists are effective in reducing menstrual blood flow. They inhibit pituitary release of FSH and LH, resulting in hypogonadism.

Danazol: This competes with androgen and progesterone at the receptor level, causing amenorrhea.

3. Surgical Therapy

Dilatation and curettage: Provides almost guaranteed relief but is a short term benefit for 2-3 months as the pathology will make the endometrium abnormal again.

4. Other Surgical modalities

a. Transcervical resection of the endometrium

b. Roller-ball endometrial ablation

c. Endometrial laser ablation

d. Uterine balloon therapy

e. Hysterectomy

f. Uterine artery embolization

Reproductive Physiology, Endocrinology, and Infertility Flashcard List

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