Oral versus rectal misoprostol in the treatment of menorrhagia

ABSTRACT

Excessive menstrual loss is a major problem. Effective medical treatments exist and its increased use will improve patient choice and provide an alternative to surgery. Evaluation of the effects of oral and rectal misoprostol in the treatment of excessive blood loss in cases of menorrhagia and comparing between both routes. Sixty women complaining of regular but heavy periods [menorrhagia] were included in the study. They were divided into two equal groups. Both groups were evaluated in two consecutive menstrual cycles. First without treatment [basal value] and the second cycle by either rectal misoprostol tablets [three times daily for the first three days of the bleeding] or by oral misoprostol tablets [one tablet three times daily for the first three days of the bleeding]. For both groups the estimated menstrual blood loss [EBL] was assessed before and after treatment using subjective and objective assessment. A highly statistical significant reduction in menstrual blood loss occurred by treatment in both groups [p=0.000]. Rectal misoprostol produced the highest reduction in the menstrual blood loss with a percent change of 53.45%, while oral misoprostol was less effective in reducing the menstrual blood loss with a percent change of 36.15% Both routes were effective in improving dysmenorrhea and reducing the number of cycle days with no significant differences between them. Both rectal and oral misoprostol are save and effective routes for reducing excessive menstrual blood loss [menorrhagia], but rectal route is more effective