Medical management of menorrhagia

First-line management of menorrhagia consists of prostaglandin inhibitors, antifibrinolytic agents, oral contraceptive pill, high dose progestogens and progesterone intra-uterine systems, which can reduce menstrual blood loss by 25%, 50%, 50%, 85% and 90%, respectively. Second-line treatment consists of danazol and GnRH agonists which reduce menstrual loss by 50% and 100%. These treatments are second line as these use is limited by side-effects and or limited duration of use.