Steroid could reduce heavy menstrual bleeding

Women who experience heavy menstrual bleeding could have their blood loss reduced by treatment with a common anti-inflammatory steroid, research suggests.

The study could pave the way for dexamethasone to be used as a safe, effective therapy—the first new class of treatment for heavy menstrual bleeding in nearly 20 years.

It is the first time an anti-inflammatory steroid has been trialed to treat this common health problem, which affects around one in four women in the UK and can persist for years.

The most commonly used treatment for reducing menstrual bleeding—a hormone-releasing device that is inserted into the womb cavity—is highly effective. However, nearly one fifth of new users are dissatisfied with the side effects, which include unpredictable bleeding. It is also unsuitable for women who are trying to get pregnant.

Treatment option

The trial—undertaken by a team from the University of Edinburgh—involved 107 women aged between 21 and 54 years old who had experienced heavy menstrual bleeding for time spans ranging from six months to 37 years.

The study found that women who were given a 0.9 mg dose of dexamethasone twice daily for five days showed an average reduction in menstrual blood loss volume of 19 percent.

Researchers say the findings mean dexamethasone could be a future treatment option for women whose heavy menstrual bleeding harms their quality of life or health. It could also be used by women who experience unacceptable side-effects with hormonal treatment but do not want surgical treatment, and those who wish to try for pregnancy.

Taboo topics

"Menstruation and heavy menstrual bleeding are still taboo topics and the debilitating impact of the latter is under-reported by patients. Our findings open the way for further study of dexamethasone as a possible safe and effective therapy," says Hilary Critchley,
professor of reproductive medicine at the University's MRC Centre for Reproductive Health.

"This trial evolved from groundbreaking laboratory research and years of multi-disciplinary collaboration between clinicians and methodologists, combined with specialist expertise in new efficient and ethical approaches to trial design. It has been an exciting and gratifying journey," says Dr. Pamela Warner, reader in medical statistics at the University's Usher Institute.