Cochrane · systematic review · CD000249
Antifibrinolytics for heavy menstrual bleeding
Bryant‐Smith, AC, Lethaby, A, Farquhar, C, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
25
current version
GRADE rated
17
No studies
8
Included studies
NR
No studies 8 · 32%Ungraded 0 · 0%Very low 8 · 32%Low 7 · 28%Moderate 2 · 8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Antifibrinolytics compared to no treatment or placebo for heavy menstrual bleeding
Population: women with heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual blood loss: mean loss Antifibrinolytics vs no treatment or placebo | no estimate extracted | 4 studies · 565 participants | Moderate Downgraded: risk of bias, imprecision |
Menstrual blood loss: improvement rates Antifibrinolytics vs no treatment or placebo | RR 3.34 [1.84, 6.09] | 3 studies · 271 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse events (any) Antifibrinolytics vs no treatment or placebo | RR 1.05 [0.93, 1.18] | 1 study · 297 participants | Low Downgraded: risk of bias, imprecision |
Thromboembolic events Antifibrinolytics vs no treatment or placebo | no estimate extracted | NR | No studies |
Antifibrinolytics compared to progestogens for heavy menstrual bleeding
Population: women with heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual blood loss: mean loss (overall) Antifibrinolytics vs progestogens | no estimate extracted | 3 studies · 312 participants | Very low Downgraded: inconsistency |
Menstrual blood loss: improvement rates (overall) Antifibrinolytics vs progestogens | RR 1.54 [1.31, 1.8] | 5 studies · 422 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events (any) Antifibrinolytics vs progestogens | RR 0.66 [0.46, 0.94] | 4 studies · 349 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Thromboembolic events Antifibrinolytics vs progestogens | no estimate extracted | NR | No studies |
Antifibrinolytics compared to NSAIDs for heavy menstrual bleeding
Population: women with heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual blood loss: mean loss Antifibrinolytics vs NSAIDs | no estimate extracted | 1 study · 49 participants | Low Downgraded: risk of bias |
Menstrual blood loss: improvement rates Antifibrinolytics vs NSAIDs | RR 1.43 [1.18, 1.74] | 2 studies · 161 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (any) Antifibrinolytics vs NSAIDs | no estimate extracted | NR | No studies |
Thromboembolic events Antifibrinolytics vs NSAIDs | no estimate extracted | NR | No studies |
Antifibrinolytics compared to ethamsylate for heavy menstrual bleeding
Population: women with heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual blood loss: mean loss Antifibrinolytics vs ethamsylate | no estimate extracted | 1 study · 53 participants | Low Downgraded: risk of bias, imprecision |
Menstrual blood loss: improvement rates Antifibrinolytics vs ethamsylate | RR 1.56 [0.95, 2.55] | 1 study · 53 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawal from treatment because of adverse events Antifibrinolytics vs ethamsylate | RR 0.78 [0.19, 3.15] | 1 study · 53 participants | Very low Downgraded: risk of bias, imprecision |
Thromboembolic events Antifibrinolytics vs ethamsylate | no estimate extracted | NR | No studies |
Antifibrinolytics compared to herbal medicines for heavy menstrual bleeding
Population: heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual blood loss: mean loss ‐ after 3 months Rx Antifibrinolytics vs herbal medicines | no estimate extracted | 2 studies · 121 participants | Low Downgraded: risk of bias |
Menstrual blood loss: mean loss ‐ after 3 months' Antifibrinolytics vs herbal medicines | no estimate extracted | 1 study · 45 participants | Very low Downgraded: risk of bias, imprecision |
Rates of improvement Antifibrinolytics vs herbal medicines | no estimate extracted | NR | No studies |
Adverse events (any) Antifibrinolytics vs herbal medicines | RR 2.25 [0.74, 6.8] | 1 study · 94 participants | Very low Downgraded: risk of bias, imprecision |
Thromboembolic events Antifibrinolytics vs herbal medicines | no estimate extracted | NR | No studies |
Antifibrinolytics compared to levonorgestrel intrauterine system
Population: heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual blood loss: median difference in PBAC score ‐ after 6 months Rx Antifibrinolytics vs levonorgestrel intrauterine system | no estimate extracted | 1 study · 42 participants | Very low Downgraded: risk of bias, imprecision |
Menstrual blood loss: improvement in mean blood loss (PBAC score < 100) Antifibrinolytics vs levonorgestrel intrauterine system | RR 0.43 [0.24, 0.77] | 1 study · 42 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (any) Antifibrinolytics vs levonorgestrel intrauterine system | RR 0.83 [0.25, 2.8] | 1 study · 42 participants | Very low Downgraded: risk of bias, imprecision |
Thromboembolic events Antifibrinolytics vs levonorgestrel intrauterine system | no estimate extracted | NR | No studies |