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The study allocated at random 571 women with menorrhagia to treatment with the LNG-IUS or medical treatment (tranexamic learn more acid, mefenamic acid, combined estrogen-progestogen, or progesterone alone). The Menorrhagia Multi-Attribute Scale (MMAS) was the patient-reported score outcome (ranging from 0 to 100), assessed over a 2-year period. MMAS scores improved from baseline to 6 months in both the LNG-IUS group and the medical treatment group (mean increase, 32.7 and 21.4 points, respectively; Pbinedaline psychological and physical well-being, although no significant between-group difference was observed regarding the domain of mental health. Tranexamic acid Tranexamic acid is a plasminogen activator inhibitor that is able to control HMB by inhibiting the dissolution of thrombosis. Oral tranexamic acid has been associated with reduced menstrual blood loss volume. However, it is not a contraceptive, cannot regulate the menstrual cycle, and could be used in women with uterine fibroids [35,36]. A recent study with a new oral formulation of tranexamic acid in women with cyclic HMB showed that during treatment tranexamic acid was well tolerated with a good safety profile and may be used as Talazoparib mouse a therapy for HMB [37]. Furthermore, it was reported [38] that a reduction in HMB was observed during therapy with tranexamic acid when compared with placebo. In two trials, tranexamic acid produced a significant reduction in mean blood loss (?94.0, 95% CI, ?151.4 to ?36.5; P:0.001) and a significant change in mean reduction of blood loss (?110.2, 95% CI, ?146.5 to ?73.8) compared with placebo. However, this improvement was not accompanied by a perceived improvement in monthly menstrual blood loss by the women [35,38]. Other researchers assessed the use of tranexamic acid on HMB. They observed a reduction in menstrual blood loss of 46.7% (95% CI, 47.9�C51.6%) with tranexamic acid [39] and others showed that oral tranexamic acid, 2.0 to 4.5 g daily, for 4 to 7 days per cycle reduced blood loss by 34�C59% [6]. However, comparing the LNG-IUS to tranexamic acid and other conventional medical therapies, a significantly large decrease in the number of bleeding days (mean, 4.0) in the LNG-IUS group compared with other therapies (mean, 2.8 days) was observed. Furthermore, the mean reduction in the number of spotting days was 0.3 days and 1.4 days, respectively [40]. Nonsteroidal anti-inflammatory drugs (such as mefenamic acid) NSAIDs are a proposed therapy in ovulatory HMB [41,42] because their use reduces menstrual loss. NSAIDs (e.g.