Intervention Review

Oral contraceptive pill for heavy menstrual bleeding

  1. Cindy Farquhar*,
  2. Julie Brown

Editorial Group: Cochrane Menstrual Disorders and Subfertility Group

Published Online: 7 OCT 2009

Assessed as up-to-date: 2 AUG 2009

DOI: 10.1002/14651858.CD000154.pub2


How to Cite

Farquhar C, Brown J. Oral contraceptive pill for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD000154. DOI: 10.1002/14651858.CD000154.pub2.

Author Information

  1. University of Auckland, Obstetrics and Gynaecology, Auckland, New Zealand

*Cindy Farquhar, Obstetrics and Gynaecology, University of Auckland, FMHS Park Road, Grafton, Auckland, 1003, New Zealand. c.farquhar@auckland.ac.nz.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 7 OCT 2009

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laienverständliche Zusammenfassung
  6. Laički sažetak

Background

Menorrhagia (heavy menstrual bleeding) is a benign yet debilitating social and health condition. Treatments prescribed in order to reduce excessive menstrual blood loss include prostaglandin synthetase inhibitors, antifibrinolytics, the oral contraceptive pill and other hormones. The combined oral contraceptive pill (OCP) is claimed to have a variety of beneficial, inducing a regular shedding of a thinner endometrium and inhibiting ovulation thus having the effect of treating menorrhagia and providing contraception.

Objectives

To determine the effectiveness of oral contraceptive pills compared with other medical therapies, placebo or no therapy in the treatment of heavy menstrual bleeding.

Search methods

We searched the Menstrual Disorders and Subfertility Group trials register (search dates: Oct 1996, May 2002, June 2004, April 2006 and June 2009) for all publications which describe randomised trials of OCP for the treatment of menorrhagia. This register is based on regular searches of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, the hand searching of 20 relevant journals and conference proceedings, and searches of several key grey literature sources.

Selection criteria

All randomised controlled comparisons of OCP versus other medical therapies, placebo or no treatment for the treatment of menorrhagia. Women of reproductive years with regular heavy periods, measured either objectively or subjectively and greater than, or equal to, two months follow up.

Data collection and analysis

All assessments of trial quality and data extraction were performed unblinded by at least two reviewers. Only one trial of 45 women met the inclusion criteria and none were excluded.

Main results

As the trial used a cross-over design, only data from the first treatment period (cycles three and four) were analysed. The results from all the three mefenamic acid groups were combined. There was no significant difference in menstrual blood loss (MBL) between those women treated with the OCP and danazol, mefenamic acid or naproxen.

Authors' conclusions

One small study found no significant difference between groups treated with OCP, mefenamic acid, low dose danazol or naproxen. Overall, the evidence from the one study is not sufficient to adequately assess the effectiveness of OCP.

This review was unable to achieve its stated objectives because of the paucity of the data.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laienverständliche Zusammenfassung
  6. Laički sažetak

Oral contraceptive pills for heavy menstrual bleeding

Heavy menstrual bleeding is a common cause for referral to gynaecologists in countries like the UK. It is a debilitating social and health condition, and it can result in anaemia. The oral contraceptive pill can provide control of the menstrual cycle and a thinner endometrium (the lining of the uterus shed during menstruation). The review showed that the pill reduced menstrual blood loss, but there are not enough data to determine its value in comparison with other drugs.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laienverständliche Zusammenfassung
  6. Laički sažetak

背景

口服避孕藥治療嚴重月經出血的效果

月經過多(嚴重月經出血)是個良性但會使人在社交或健康狀況失去活力的症狀。降低過多經血流失的治療處方包括前列腺素合成脢抑制劑(prostaglandin synthetase inhibitors)、抗纖維蛋白溶解劑(antifibrinolytics)、口服避孕藥(oral contraceptive pill: OCP)及其他賀爾蒙。複方口服避孕藥聲稱其具有多種好處,包括讓較薄的子宮內膜可以定期排出也可抑制排卵,因此可以治療月經過多及提供避孕之效。

目標

評估口服避孕藥相較於其他藥物治療、安慰劑、或無治療對於月經過多的效果。

搜尋策略

我們搜尋了the Menstrual Disorders and Subfertility Group trials register (搜尋日期:1996年10月、 002年5月、2004年六月、2006年四月以及2009年6月 中探討口服避孕藥治療月經過多相關議題已發表之隨機對照試驗研究。這份登錄是基於定期搜尋MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials: (CENTRAL), PsycINFO 等資料庫, 並手動搜尋20本相關的期刊與研討會議論文, 以及一些具關鍵性的舊有文獻資源之調查所得之結果。

選擇標準

收納所有因月經過多給予口服避孕藥與其它藥物療法、安慰組或不予治療組之隨機對照試驗研究。對象為育齡婦女有規則之嚴重月經出血週期,以客觀或主觀評估治療效果並追蹤大於或等於兩個月。

資料收集與分析

所有研究品質的評估及資料萃取,至少由兩位審查作者來執行。只有一篇45位參試婦女的研究符合納入標準,沒有文章被排除。

主要結論

因為研究設計方法採用交叉試驗,所以只分析第一個治療週期(即第三及第四週期)。所有使用mefenamic acid的三組結果合併起來. 結果發現在治療經血流失這方面,用口服避孕藥與danazol、mefenamic acid或naproxen間並無顯著差異。

作者結論

一篇小型的研究發現用口服避孕藥、mefenamic acid、低劑量danazol或naproxen治療月經過多,彼此間並無顯著差異。整體而言,由單篇研究得到的證據不足以適當地評估口服避孕藥其治療效果。

翻譯人

本摘要由高雄醫學大學附設醫院許郁笙翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

並無足夠的資料顯示口服避孕藥治療嚴重月經出血的效果。在一些國家,例如英國,月經過多(嚴重月經出血)是常見被轉介至婦科醫師治療的原因之一。它是種會使人在社交或健康狀況失去活力的症狀而且會造成貧血。口服避孕藥可提供月經週期的控制以及較薄的子宮內膜(是一層在月經期間會脫落的子宮內襯)。這篇回顧性文章顯示口服避孕藥可減少經血流失,但是並無足夠的資料評估其與其他藥物相比較下用於治療月經過多的價值如何。

 

Laienverständliche Zusammenfassung

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laienverständliche Zusammenfassung
  6. Laički sažetak

Orale Verhütungsmittel bei schweren Monatsblutungen

Schwere Monatsblutungen (Menorrhagie) ist in Ländern wie Großbritannien ein häufiger Grund für Überweisungen an einen Frauenarzt. Sie können sich sozial und gesundheitlich sehr negativ auswirken und zu Blutarmut führen. Die sogenannte 'Pille' (orales Verhütungsmittel) kann den Menstruationszyklus regulieren und zu einer dünneren Gebärmutterschleimhaut führen, die während der Regelblutung abgestoßen wird. Dieser Review zeigt, dass die 'Pille' den Blutverlust bei der Regelblutung verringerte, aber die Daten sind nicht ausreichend, um sie im Vergleich zu anderen Medikamenten, die in der Behandlung der Menorrhagie verwendet werden, zu bewerten.

Anmerkungen zur Übersetzung

Koordination durch Cochrane Schweiz

 

Laički sažetak

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laienverständliche Zusammenfassung
  6. Laički sažetak

Kontracepcijske pilule za obilno menstrualno krvarenje

Obilno menstrualno krvarenje često dovodi žene ginekologu u razvijenim zemljama. Radi se o teškom stanju koje ugrožava zdravlje i funkcioniranje u društvu te može dovesti do anemije. Kontracepcijske pilule mogu kontrolirati menstrualni ciklus i stanjiti unutarnji sloj maternice koji se ljušti tijekom menstruacije (endometrij). Ovaj Cochrane sustavni pregled pokazao je da kontracepcijske pilule smanjuju gubitak krvi, ali nije pronađeno dovoljno podataka za usporedbu s drugim lijekovima.

Bilješke prijevoda

Hrvatski Cochrane
Prevela: Livia Puljak
Ovaj sažetak preveden je u okviru volonterskog projekta prevođenja Cochrane sažetaka. Uključite se u projekt i pomozite nam u prevođenju brojnih preostalih Cochrane sažetaka koji su još uvijek dostupni samo na engleskom jeziku. Kontakt: cochrane_croatia@mefst.hr