Vaginal Danazol for Abnormal Uterine Bleeding

Danazol shortened duration and diminished severity of menstrual bleeding with minimal side effects.

Several medical approaches are available for management of abnormal uterine bleeding during the reproductive years. Italian investigators assessed the efficacy of vaginally administered danazol (a synthetic steroid that suppresses the pituitary–ovarian axis) for treating women with heavy menstrual bleeding. Fifty-five women (median age, 33) with histories of heavy menstrual bleeding underwent biopsies to exclude endometrial hyperplasia, polyps, and submucous fibromas. Participants inserted single 200-mg vaginal danazol tablets nightly for 6 months and recorded menstrual bleeding (on a visual analog scale), side effects, and pain.

At 6 months, all women reported shorter menses (from 6 to 3 days) and fewer pads or tampons used (from 6 to 2 daily) than at study entry. In 90% of the women, severity of blood loss was reduced after 3 months. Hematocrit, hemoglobin, and red blood cell count were higher in all participants at the end of the study; moreover, dysmenorrhea, dyspareunia, and pelvic pain were substantially diminished. The only reported side effect was vaginal irritation in two women. At 6 months, 80% of participants were very satisfied with the treatment, 16% were satisfied, and 4% were uncertain. During the study, 22 of the 30 women who wanted to become pregnant conceived spontaneously.