From the Guidelines
Toradol (ketorolac) can be used to temporarily reduce menstrual bleeding, but it's recommended to use it for a short-term period of 5 days maximum due to side effect risks, as suggested by the most recent guidelines 1. When considering treatment options for managing heavy menstrual bleeding, it's essential to weigh the benefits and risks of each medication.
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (600-800mg every 6-8 hours) or naproxen (500mg twice daily) are commonly recommended for short-term use, starting 1-2 days before the period and continuing through heavy flow days 1.
- Hormonal options, such as birth control pills, hormonal IUDs, or tranexamic acid (Lysteda, 1300mg three times daily during heavy bleeding days), are typically more effective for controlling menstrual bleeding, as they work by either stabilizing the uterine lining or reducing prostaglandin production 1. Key points to consider when choosing a treatment option include:
- The patient's medical history and preferences
- The underlying cause of the heavy menstrual bleeding
- The potential side effects and risks associated with each medication It's crucial to consult with a healthcare provider to determine the most appropriate treatment option for each individual's specific situation, as they can help identify the underlying cause of the bleeding and recommend the best course of treatment 1.
From the Research
Medications to Stop or Reduce Menstrual Bleeding
- Toradol (ketorolac) is a nonsteroidal anti-inflammatory drug (NSAID) that can help reduce menstrual bleeding by decreasing prostaglandin levels 2, 3.
- Other NSAIDs, such as naproxen and mefenamic acid, have also been shown to reduce menstrual blood loss by 20-60% 4, 2, 3.
- Tranexamic acid is a more effective medication for reducing heavy menstrual bleeding, with a reduction of 40-60% 5, 4, 2, 3.
- Hormonal intrauterine systems (IUS), such as the levonorgestrel-releasing IUS, can also reduce menstrual bleeding by thinning the lining of the uterus 4, 2.
Prostaglandins and Menstrual Bleeding
- Prostaglandins play a role in menstrual bleeding, and their levels are elevated in women with excessive menstrual bleeding 6.
- Prostaglandin synthetase inhibitors, such as naproxen, can reduce menstrual blood loss by decreasing prostaglandin levels 6.
- The mechanism of action of prostaglandins in menstrual bleeding is not fully understood, but they may affect the stability of lysosomes, platelet aggregation, and coagulation factors, leading to increased menstrual bleeding 6.
Treatment Options
- NSAIDs, such as Toradol, can be used to reduce menstrual bleeding, but they may be less effective than other medications like tranexamic acid or hormonal IUS 4, 2, 3.
- Treatment should be started with one of the drug therapies, such as NSAIDs, tranexamic acid, or hormonal IUS, and evaluated before surgical interventions are considered 4.