Comparison between antifibrinolytic and antiprostaglandin treatment in the reduction of increased menstrual blood loss in women with intrauterine contraceptive devices

The effects of a fibrinolysis inhibitor [tranexamic acid, TA] and prostaglandin synthesis inhibitor [diclofenac sodium, DS] were compared in the reduction of excessive menstrual blood loss in 19 women with an intrauterine contraceptive device [IUCD]. These women [mean blood loss before treatment to 135. 1 + 18.9 SE ml, range 70-294 ml] were treated in random order with TA [1.5g three times daily for 5 days starting on the first day of menstruation for two periods], and with DS [50 mg three times on the first day followed by 25 mg three times daily for 4 days, for two periods], or with placebo [one period] in a double-blind trial. The placebo treatment did not change menstrual blood loss [128.3 + 15.6 ml]. The T A treatment decreased blood loss to 59.4+7.7 ml [P<0.001] and the DS treatment to 102.1 + 13.6 ml [P<0.01]. Neither treatment abolished pelvic discomfort during menstruation or shortened its duration. Various side-effects were noted by 12 women during 19 TA treatments and by five women during six DS treatments. Thus, while TA is generally far more effective, DS gave pronounced decreases in menstrual bleeding in some women and had less frequent side-effects

Inibidores de prostaglandinas e eficácia do dispositivo intrauterino em coelhas / Prostaglandin inhibitors and efficacy of intrauterine device in rabbits

Para verificar se há diminuiçäo da eficácia contraceptiva do dispositivo intrauterino (DIU), com o emprego clínico de inibidores de prostaglandina (PG), para tratar efeitos colaterais do DIU, 88 coelhas foram usadas para medicaçäo oral e intrauterina com fentiazac, um potente inibidor de PGs. Com administraçäo oral de 10mg/kg de peso, entre os dias 1 e 5 após a fertilizaçäo näo se encontrou qualquer efeito sobre o número ou sobre a histologia dos blastocistos, obtidos no 6§ dia. Quando a mesma dose foi administrada entre os dias 4 e 7 pós-fertilizaçäo e sacrificio no 28§ dia, näo houve alteraçäo no número de implantes ou fetos vivos. Com a administraçäo intrauterina, por meio de DIUs, medicados e näo medicados, em cada corno de útero da coelha, no dia anterior à inseminaçäo, tanto na concentraçäo de 1mg como 10mg por DIU, só houve diferença no número de implantes, sendo maior nos cornos tratados (37,2) que nos näo medicados (21,9), mas näo houve diferença no número de fetos vivos. Conclui-se sugerindo que o uso de inibidor de PG näo diminui a eficácia contraceptiva do DIU.