EACA was clearly effective in reducing menstrual blood loss in women using IUDs. Our results do not support previous claims,4 based on subjective improvement and a reduction in tampon usage, that ethamsylate reduces menstrual loss. The patients treated by Gaudefroy and Debienne-Wibaux,4 however, had various gynaeclogical conditions but were not using IUDs, and they received ethamsylate for five days before the onset of menstruation and during menstruation. Caution must also be expressed about accepting the accuracy of menstrual blood loss based entirely on counting tampons. Enhanced fibrinolysis in the uterus seems to play a significant part in IUD menorrhagia,5 and EACA, with its potent antifibrinolytic effect, seems to be a rational and effective way of reducing the excessive menstrual bleeding that occurs with the IUD.
B R Reeves, V L Pickup, S D Lawler
British Medical Journal