Publication:

Diosmin versus tranexamic acid in heavy menstrual bleeding: a randomized controlled trial

Background Heavy menstrual bleeding (HMB) is defined as cyclical bleeding at regular intervals but excessive in amount which affect the physical, social and mental aspects of life of a woman. The prevalence is 10-30% in reproductive age women and 50% in perimenopausal women. HMB is not just a clinical burden but also a huge social and economic burden. The aims and objective of my study is to compare the efficacy of diosmin and tranexamic acid in acute HMB in terms of average duration of menstrual cycle, PBAC/PABC score, endometrial thickness, hemoglobin concentration and finally need for other modes of treatment.

Methods The study was a randomized control trial in which the patients (sample size-72) were divided into two groups- group D (n=36) and group T (n=36). Group D was treated with tab diosmin 500 mg thrice daily from day 1 to day 5 of menstrual cycle. Similarly group T was treated with tab tranexamic acid 500 mg thrice daily from day 1 to day 5 of menstrual cycle. The PBAC score was taken at the end of three months along with endometrial thickness and hemoglobin concentration. The results were compared with values obtained before initiating treatment.

Results In this study after 3 months of treatment; the patients in group D had an initial PBAC score of 423.52 and at the end of treatment it was decreased to 149.89 (p<0.0001). Reduction was 60.5%. Group T patients had an initial PBAC score of 441which was reduced to 177.94 (p<0.0001) after treatment. The reduction in this group was 59.6%.

Conclusions In this study it was found that both tranexamic acid and diosmin were effective in reduction of HMB, in terms of PBAC score, average duration of menstrual cycle and endometrial thickness. But the in reduction in PBAC score was similar in both the groups. The failure rates were also similar in both the groups, but improvements in hemoglobin concentration were only marginal