Researchers believe that a steroid that rose to prominence during the Covid epidemic may reduce blood loss for those who have heavy periods.
Patients with Covid were found to have higher survival rates when they took the cheap anti-inflammatory drug dexamethasone. It can also be used to treat severe asthma and some forms of arthritis.
Researchers now believe that dexamethasone may reduce blood loss in women who have heavy periods. This is according to a small study. Studies suggest that it could affect between 20% and 52% of UK women.
According to Dr Pamela Warner (co-author of the University of Edinburgh's research, heavy menstrual bleeding can have a huge impact on lives, particularly for certain jobs or life circumstances.
She also expressed concern about the impact iron depletion due to excessive menstrual bleeding on general health, especially in countries that have less access to universal healthcare services.
She said that the IUS [intrauterine system] is currently the most popular [treatment]. It is also a contraceptive. This protects against pregnancy but is not suitable for all women, especially those who don't want to use synthetic reproductive hormones. It is also not recommended for pregnant women.
Dexamethasone may be an option.
Warner and her colleagues published their findings in the journal EBioMedicine. They analyzed data from 97 women aged 18 to participate in the study. The majority of women experienced heavy periods with 50ml blood loss over two periods. Regular periods lasted 21 to 42 day.
Participants were randomly assigned to receive either a placebo or one the six doses of dexamethasone. These were taken twice daily for five days during the phase of their menstrual cycles before they began. The process was repeated for each of the three menstrual cycles.
Although dexamethasone may reduce blood volume during periods, the strongest and most durable effect was observed for those who took 1.8mg per day. Participants on the program had an average decrease in menstrual bleeding of 25ml compared to those on placebo. The team 95% believes that this reduction is between 1ml-49ml. According to the authors, this dosage group experienced a relative 19% reduction in menstrual volume loss compared to their individual baseline.
According to the team, dexamethasone may be an effective tool in reducing heavy menstrual bleeding.
Warner said that it is the first medical treatment for heavy bleeding in nearly 20 years. This is a significant development over existing methods.
She said that although three serious adverse events were reported during the trial, none were experienced by those taking dexamethasone. However, there were reports of mild side effects such as dizziness and headaches.
Warner suggested that future research could include delivering the steroid via self-applied vaginal syringe or another local method. This would allow for a lower dose and may reduce side effects.
Royal College of Obstetricians and Gynaecologists said they welcomed research into heavy menstrual flow, but expressed concern about the small sample size and the unknown long-term adverse effects. The RCOG requested a second trial with a larger sample size.
However, Dr Annalise Wckesser, a Birmingham City University medical anthropologist who specializes in gender and reproductive health, said there was a lot of overlap between women who have heavy menstrual periods and those with endometriosis.
Over the past two decades, women who suffer from heavy menstrual bleeding/endometriosis (sometimes debilitating and often disruptive) have complained that their limited options are ineffective or cause side effects.
Although further research is required on the use dexamethasone for heavy menstrual bleeding, given the lack of breakthroughs in women's reproductive health, this study is encouraging and suggests that there may be a non-hormonal or non-surgical solution.