Review question

Cochrane authors investigated whether non-steroidal anti-inflammatory drugs (NSAIDs) helped reduce heavy menstrual bleeding (HMB) in women before they reach the menopause.

Background

NSAIDs reduce prostaglandin levels, which are elevated in women with excessive menstrual bleeding. It was suggested that they might help with heavy bleeding and may have a beneficial effect on painful menstrual periods.

Study characteristics

Authors search medical databases and identified 19 randomised controlled trials ( RCTs ; clinical studies where people are randomly put into one of two or more treatment groups) with 759 women that could be included in the review , but data from only nine trials were suitable for analyses.

Key results

Women sought help for HMB when it affected their quality of life. Levels of prostaglandin (a naturally occurring hormone ) are higher in women with HMB and are reduced by NSAIDs. The review of trials found that NSAIDs were modestly effective in reducing HMB, but other medicines, such as danazol, tranexamic acid and levonorgestrel-releasing intrauterine system (LNG IUS), are more effective. These results were based on a small number of low- to moderate-quality trials.

Quality of the evidence