Abstract
Study Objective
Heavy menstrual bleeding (HMB) occurs in up to 40% of adolescent girls, significantly
affecting their daily activities. Identifying alternative treatment strategies for
HMB is particularly important for adolescents who prefer not to take hormonal contraception.
Our objective was to determine whether use of tranexamic acid (TA) would increase
health-related quality of life and decrease menstrual blood loss (MBL) in adolescents
with HMB.
Design, Setting, Participants, Interventions, and Main Outcome Measures
In an open-label, multi-institutional, single-arm, efficacy study, patients 18 years
of age or younger with HMB were treated with oral TA 1300 mg 3 times daily during
the first 5 days of menses and monitored over the course of 4 menstrual cycles (1
baseline; 3 treatment cycles). Assessment of MBL was performed using the Menorrhagia
Impact Questionnaire (MIQ) and the Pictorial Blood Assessment Chart. The MIQ includes
Likert scale items, validated to assess the influence of HMB on quality of life. In
previous studies, a 1-point decrease or more in score correlated with clinically significant
improvement.
Results
Thirty-two patients enrolled in the study, and 25 had sufficient follow-up data to
be deemed evaluable. The mean age of the participants was 14.7 years (range, 11-18 years).
There was an overall improvement in all items of the MIQ, with a greater than 1-point
improvement in the MIQ perceived blood loss scale. When using TA, mean Pictorial Blood
Assessment Chart score improved by 100 points. There were no medication-related serious
adverse events.
Conclusion
Use of TA in female adolescents with HMB is well tolerated and leads to clinically
meaningful reduction in MBL.
Key Words
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Article info
Publication history
Published online: February 04, 2019
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2019 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
