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Effects of mefenamic acid on menstrual hemostasis in essential menorrhagia

  • Author Footnotes
    a From the Department of Gynecology and Obstetrics, University Hospital Utrecht.
    Marion A. van Eijkeren
    Correspondence
    Reprint requests: M.A. van Eijkeren, MD, PhD, Department of Obstetrics and Gynecology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
    Footnotes
    a From the Department of Gynecology and Obstetrics, University Hospital Utrecht.
    Affiliations
    Utrecht, The Netherlands
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  • Author Footnotes
    a From the Department of Gynecology and Obstetrics, University Hospital Utrecht.
    Godelieve C.M.L. Christiaens
    Footnotes
    a From the Department of Gynecology and Obstetrics, University Hospital Utrecht.
    Affiliations
    Utrecht, The Netherlands
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  • Author Footnotes
    b Laboratory of Cell Biology, University Hospital Utrecht.
    Hans J. Geuze
    Footnotes
    b Laboratory of Cell Biology, University Hospital Utrecht.
    Affiliations
    Utrecht, The Netherlands
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  • Author Footnotes
    a From the Department of Gynecology and Obstetrics, University Hospital Utrecht.
    Ary A. Haspels
    Footnotes
    a From the Department of Gynecology and Obstetrics, University Hospital Utrecht.
    Affiliations
    Utrecht, The Netherlands
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  • Author Footnotes
    c the Department of Hematology, University Hospital Utrecht.
    Jan J. Sixma
    Footnotes
    c the Department of Hematology, University Hospital Utrecht.
    Affiliations
    Utrecht, The Netherlands
    Search for articles by this author
  • Author Footnotes
    a From the Department of Gynecology and Obstetrics, University Hospital Utrecht.
    b Laboratory of Cell Biology, University Hospital Utrecht.
    c the Department of Hematology, University Hospital Utrecht.
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      Prostaglandin synthesis inhibitors decrease menstrual blood loss by 30% to 50% in patients with essential menorrhagia. To obtain insight into their mechanism of action, we measured menstrual blood loss in menorrhagic women, who were receiving mefenamic acid (500 mg, three times daily) (n = 6) or placebo (n = 5) in a double-blind way. In addition we studied the morphology of early menstrual hemostasis. The subjects' uteri were extirpated in the first 24 hours of menstruation, and light and electron microscopy were used to perform morphologic and morphometric studies. In the group treated with mefenamic acid mean menstrual blood loss was decreased by 40%. In uteri of the women treated with mefenamic acid hemostatic plugs were further transformed, and fewer vessels without a plug were observed than in uteri of the group receiving placebo. These data suggest that mefenamic acid may act through an improvement of platelet aggregation and degranulation and through increased vasoconstriction.

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      References

        • Anderson ABM
        • Haynes PJ
        • Guillebaud J
        • Turnbull AC
        Reduction of menstrual blood loss by prostaglandin synthetase inhibitors.
        Lancet. 1976; 1: 774-776
        • Fraser IS
        • Pearse FC
        • Shearman RP
        • Elliot PM
        • McIlveen J
        • Markham R
        Efficacy of mefenamic acid in patients with a complaint of menorrhagia.
        Obstet Gynecol. 1981; 58: 543-551
        • Rybo G
        Plasminogen activators in the endometrium.
        Acta Obstet Gynecol Scand. 1966; 45: 411-450
        • Smith SK
        • Kelly RW
        • Abel MH
        • Baird DT
        A role for prostacyclin (PGI2) in excessive menstrual bleeding.
        Lancet. 1981; 1: 522-524
        • Smith SK
        • Abel MH
        • Kelly RW
        • Baird DT
        Prostaglandin synthesis in the endometrium of women with ovular dysfunctional bleeding.
        Br J Obstet Gynaecol. 1981; 88: 434-442
        • Cameron IT
        • Kelly RW
        • Baird DT
        Prostaglandins in the human uterus: an interaction between endometrium and myometrium.
        Prostaglandins Leukot Med. 1985; 17: 329-335
        • Mäkäräinen L
        • Ylikorkala O
        Primary and myoma-associated menorrhagia: role of prostaglandins and effect of Ibuprofen.
        Br J Obstet Gynaecol. 1986; 93: 974-978
        • Adelanto JM
        • Rees MRP
        • Lopez Bernai A
        • Turnbull AC
        Increased uterine prostaglandin E receptors in menorrhagic women.
        Br J Obstet Gynaecol. 1988; 99: 162-165
        • Tsang BK
        • Domingo MT
        • Spence JEH
        • Garner PR
        • Dudley DK
        • Oxorn H
        Endometrial prostaglandins and menorrhagia: influence of a prostaglandin inhibitor in vivo.
        Can J Physiol Pharmacol. 1987; 65: 2081-2084
        • Rees MCP
        • Canete-Soler R
        • Lopez Bernai A
        • Turnbull AC
        Effect of fenamates on prostaglandin E receptor binding.
        The Lancet. 1988; 11: 541-542
        • Wester J
        • Sixma JJ
        • Geuze JJ
        • Heijnen HFG
        Morphology of the hemostatic plug in human skin wounds. Transformation of the plug.
        Lab Invest. 1979; 41: 182-192
        • Christiaens GCML
        • Sixma JJ
        • Haspels AA
        Morphology of haemostasis in menstrual endometrium.
        Br J Obstet Gynaecol. 1980; 87: 425-439
        • Van Eijkeren MA
        • Christiaens GMCL
        • Geuze JJ
        • Haspels AA
        • Sixma JJ
        Morphology of menstrual hemostasis in essential menorrhagia.
        Lab Invest. 1991; 64: 284-294
        • Van Eijkeren MA
        • Scholten PC
        • Christiaens GCML
        • Alsbach GPJ
        • Haspels AA
        The alkaline hematin method for measuring menstrual blood loss-a modification and its clinical use in menorrhagia.
        Eur J Obstet Gynecol Reprod Biol. 1986; 22: 345-351
        • Kubasik NP
        Evaluation of a direct solid-phase radioim-munoassay: for progesterone.
        Clinical Chem. 1984; 30: 284-286
        • Weibel ER
        Principles and methods for the morphometric study of the lung and other organs.
        Lab Invest. 1963; 12: 131-155
        • Wester J
        • Sixma JJ
        • Geuze JJ
        • Van der Veen J
        Morphology of the early hemostasis in human skin wounds. Influence of acetylsalicylic acid.
        Lab Invest. 1978; 39: 298-311
        • Hahn L
        • Petrusson B
        The influence of acetylsalicylic acid and paracetamol on menstrual blood loss in women with and without an intrauterine contraceptive device.
        Am J Obstet Gynecol. 1979; 135: 393-396
        • Granström E
        • Swahn ML
        • Lundström V
        The possible roles of prostaglandins and related compounds in endometrial bleeding.
        Acta Obstet Gynecol Scand. 1983; 113: 91-99