WHAT ARE THE NONHORMONAL AGENTS USED FOR TREATING DUB ?

Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

• Nonsteroidal anti-inflammatory drugs (NSAIDs) block prostaglandins (the substances that increase uterine contractions).
  
• They also have other properties that act against inflammatory factors that may be responsible for heavy menstrual bleeding.
  
• Studies suggest that they reduce bleeding by 30% to 50% and are the first choice for most women who experience heavy menstrual bleeding.
  
• Aspirin is the most common NSAID, but there are dozens of others available over the counter or by prescription. Among the most effective NSAIDs for menstrual disorders are ibuprofen, naproxen and mefenamic acid.
  
• Mefenamic acid has been intensively studied and has been shown to reduce bleeding by 30% to 50%.
  
• For maximum benefit, they should be taken seven days before a period is expected.
  
• It should be noted, however, that long-term use of any NSAID can increase the risk for gastrointestinal bleeding and ulcers.

Tranexamic Acid.

• Tranexamic acid is a synthetic form of the amino acid lysine and enhances blood clotting.
  
• It reduces menstrual blood flow by about half.
  
• It is more effective in reducing blood flow than oral progestins or NSAIDs, but is not as effective as the progestin-releasing IUD (LNG-IUS).
  
• Women reported a better quality of life with tranexamic acid than with oral progestins.
  
• Side effects, however, can include headache, nausea, and gastrointestinal distress.
  
• Tranexamic acid may be a good treatment choice for menorrhagia not caused by fibroids, endometriosis, or other uterine lesions and when hormonal agents are not an option.
  
• Women with any risk factors for blood clots should not use this agent.