Abstract Number: PB0690
Meeting: ISTH 2021 Congress
Background: Hormonal therapy and Tranexamic acid (TXA) are often used as a first line therapy for the management of heavy menstrual bleeding (HMB).
Aims: The aim of this study is to review effectiveness and safety of their concurrent use in women with bleeding disorders.
Methods: Retrospective data collected from electronic patient records of 87 women managed with TXA and hormonal therapy for HMB. Data collected included demographics, indication, dosage, duration of use of TXA and hormonal therapy, side effects and response to treatment.
Results: The median age was 20-29 (range 10-54) years, 23(26%) were overweight or obese. None had a personal or family history of VTE. Von Willebrand disease was the commonest bleeding disorders affecting 31 (36%) women. The bleeding disorder was classified a severe, moderate and mild in 24(35%), 13(22%) and 26(43%). Median pictorial blood assessment chart score was 137. 19(22%) had iron deficiency anaemia and 7(8%) had uterine fibroids.
The median duration for the combination therapy was 4 years with 34(39%) of women using the treatment for more than 5 years. Hormonal therapies used were combined oral contraceptives in 42 (48%) women, LNG-IUS in 14 (16%), cyclical progesterone in 16(18%), desogestrel 75mcg in 9 (10%).81 (93%) of women used TXA only during the period; 41(47%) required TXA use for more than 7 days a month.
Median PBAC score at 6 months of treatment was 71 and 77(89%) women rated the combined therapy as effective. Surgical intervention reported in 8 (9%) women. Treatment discontinuation of the combined therapy was reported in 4(5%) due to side effects; but 10 (11%) women discontinued only hormonal therapy use due to irregular spotting or hormonal side-effects. No VTE reported in any women.
Conclusions: Concurrent use of TXA and hormonal therapy is safe, effective and well tolerated in women with bleeding disorders with HMB.
To cite this abstract in AMA style:Epstein A, Turan O, Abdul-Kadir R. Concurrent Use of Tranexamic Acid and Hormonal Therapy: Management of Heavy Menstrual Bleeding in Women with Inherited Bleeding Disorders [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/concurrent-use-of-tranexamic-acid-and-hormonal-therapy-management-of-heavy-menstrual-bleeding-in-women-with-inherited-bleeding-disorders/. Accessed November 29, 2021.
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