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  • Title: Studies in menorrhagia: (a) mefenamic acid, (b) endometrial prostaglandin concentrations.
    Author: Haynes PJ, Flint AP, Hodgson H, Anderson AB, Dray F, Turnbull AC.
    Journal: Int J Gynaecol Obstet; 1980; 17(6):567-72. PubMed ID: 6106574.
    Abstract:
    Twenty-two women with unexplained heavy menstrual blood loss (average loss for two cycles of >80 ml) were treated with the prostaglandin synthetase inhibitor menfenamic acid during two consecutive menstruations. There was a significant reduction in menstrual blood loss on mefenamic acid therapy, the median loss being 137 ml before treatment and 76 ml while on treatment. Reduction in menstrual loss was achieved in 20 of the 22 patients but varied from a 2% to 78% reduction. The greater the menstrual loss before treatment, the more it was reduced on mefenamic acid therapy. Endometrial concentrations of prostaglandins E2 and F2 alpha in the follicular phase of the cycle were similar whether or not patients had menorrhagia. In the luteal phase, however, 6 of 14 patients with menorrhagia had higher endometrial prostaglandin E2 and F2 alpha concentrations than all 13 controls. To determine whether prostaglandin (PG) levels in the endometrium are related to menstruation disorders, 22 women with unexplained heavy menstrual loss (greater than 80 ml) were treated with the PG synthetase ihhibitor mefenamic acid during 2 consecutive menstrual cycles. In addition, measurements were also made of the PGE2 and PGF2 alpha levels in the endometrium of women with menorrhagia, and these were compared with levels in women with normal menstrual blood loss. Therapy was oral adminstration of mefenamic acid 4 times daily for the first 3 days of heavy bleeding (500 mg/tablet). Before treatment, the median value of blood loss was 137 ml, whereas after treatment this value dropped to 76 ml. There was, however, considerable individual variation in patient response to mefenamic acid, varying from 2-78% reduction. There was a highly significant positive correlation (P .01), nevertheless, between average pretreatment menstrual loss and average reduction in menstrual loss during therapy. In general, the greater the menstrual loss before treatment, the more it was reduced on mefenamic acid therapy. Endometrial concentrations of PGs in the follicular stage were similar whether patients suffered from menorrhagia or not; however, it was determined that during the luteal phase, 6 of 14 patients with menorrhagia had higher endometrial PGs than did all 13 control subjects.
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