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ROLE OF MEFENAMIC ACID IN MANAGEMENT OF HEAVY MENSTRUAL BLEEDING OF ENDOMETRIAL ORIGIN
*Zoya Daoud, Maisoon Dayoub and Ahmed Youseef
Background: Heavy menstrual bleeding (HMB) is a common clinical problem among reproductive women .Anemia which may be difficult to treat even with continuous iron therapy is the most common complication, in addition to adverse impact on women's physical psychological and social life .The abnormal uterine bleeding of endometrial dysfunction is thought that is the result of increased blood loss from vasodilation due to prostaglandins or from increased fibrinolytic activity within the endometrium .So we suggest that Nonsteroidal anti-inflammatory drugs (NSAIDs) which prevent formation of prostaglandins, have high efficacy in reducing menstrual blood loss and also pain Objective Main purpose: study the efficacy of mefenamic acid in management heavy menstrual Bleeding Second purpose : 1-the prevalence of primary dysmenorrhea in our study's patients. 2-study the efficancy of MFA in reducing the severity of abdominal pain in patients with dysmenorrhea .3-Adverse side effects during treatment .Methods :An experimental pilot study (prospective) covered 50 patients among 19-33 years old ,presented with heavy menstrual bleeding after excluding pregnancy, structural and iatrogenic causes coagulation defects and ovulatory disorders at Tishreen university Hospital in Lattakia between 2021- . Complete menstrual history was taken pregnancy test was done, physical examination and Ultrasound were performed.We gave them mefenamic acid 500 mg tablets three times daily from the first to the fifth Day of menstrual bleedi .Pictorial bleeding assessment chart (PBAC) number of pads ,cycle Duration and Hemoglobin level.were used for assessing blood loss volume. Visual Analog Scale (VAS) was used for assessing the severity of pain. Results: The current study showed that after initiation of treatment by Mefenamic acid, a decrease in bleeding loss volume (PBAC score) was observed with statistically significant differences. The decrease after a month was 19%, after 2 months was 34% ,after three months was 38% .There was a significant decrease in number of pads as follow (17% after 1st month, 32% after 2nd month, 35% after 3rd month) There was a decrease in cycle duration without statistically differences. The hemoglobin level was increased significantly (4%). 88%Of patients had dysmenorrhea along with heavy menstrual bleeding and a statistically significant decrease in VAS score was observed after 3 months of treatment (75%). Conclusion: Mefenamic acid has high efficacy in reducing menstrual bleeding and reducing pain and is available, short-term treatment with few side effects.[Full Text Article]