Abnormal uterine bleeding and hypermenstrual syndrome: new clinical horizons

Authors

  • T.F. Tatarchuk SI “Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine»; SSI «Center of Innovative Medical Technologies of the NAS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0002-5498-4143
  • N.V. Kosei SSI «Center for Innovative Medical Technologies of the NAS of Ukraine»; SI «Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0003-3085-3285
  • S.I. Regeda SSI «Center for Innovative Medical Technologies of the NAS of Ukraine»; SI «Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0002-4960-7175
  • L.O. Borisova SI «Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine», Kyiv; Municipal Non-Profit Enterprise «First Territorial Medical Association of Lviv», Lviv, Ukraine https://orcid.org/0009-0004-5873-1372
  • T.E. Krisenko SI «Ukrainian Center for Maternity and Childhood of the NAMS of Ukraine»; SI «Heart Institute of the Ministry of Health of Ukraine», Kyiv, Ukraine https://orcid.org/0009-0003-1934-3687
  • R.O. Mnevets SI “Ukrainian Center of Maternity and Childhood of the National Academy of Medical Sciences of Ukraine»; Educational and Scientific Centre «Institute of Biology and Medicine» of Taras Shevchenko National University of Kyiv, Kyiv, Ukraine https://orcid.org/0000-0001-9614-5762

DOI:

https://doi.org/10.18370/2309-4117.2026.82.34-45

Keywords:

abnormal uterine bleeding, hypermenstrual syndrome, tranexamic acid, Tazalok, herbal medicine, iron metabolism, neurovegetative symptoms

Abstract

Objective of the study: to evaluate the clinical effectiveness of combined non-hormonal therapy in women of reproductive age with heavy menstrual bleeding (hypermenstrual syndrome), specifically assessing the impact of adding the herbal medicinal product Tazalok to symptomatic treatment with tranexamic acid on menstrual blood loss volume, bleeding duration, iron metabolism parameters, neurovegetative status, and quality of life.

Materials and methods. A prospective comparative clinical study included 100 women of reproductive age diagnosed with abnormal uterine bleeding of the heavy menstrual bleeding type. Participants were divided into two equal groups (n = 50 each). Group I received tranexamic acid during menstruation. Group II received tranexamic acid according to the same regimen combined with the Tazalok. Assessments were performed at baseline and after 1, 2, and 3 months of therapy. Menstrual blood loss was quantified using the Pictorial Blood Loss Assessment Chart (PBAC), and bleeding duration was recorded in days. Laboratory evaluation included hemoglobin, ferritin, follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, prolactin and cortisol levels. Neurovegetative and psychoemotional symptoms (headache, sleep disturbances, emotional lability, anxiety, tearfulness, fatigue) were assessed before and after treatment.

Results. During the three-month follow-up, both groups demonstrated a significant reduction in menstrual blood loss and bleeding duration compared with baseline (p < 0.05). After three months, mean blood loss decreased to 86.3 ± 7.7 mL in Group I and 63.4 ± 5.1 mL in Group II, with significantly lower values in the combined therapy group (p = 0.017). Bleeding duration shortened to 6.3 ± 0.25 days and 5.2 ± 0.21 days, respectively, with between-group differences becoming significant from the first month of treatment (p = 0.0045) and persisting thereafter (p = 0.0014). In Group II, the rate of complete symptom resolution was higher for hypermenorrhea (54% vs 36%), metrorrhagia (48% vs 40%), and intermenstrual bleeding (40% vs 32%), while the proportion of cases without clinical improvement was lower (4–6% vs 10.0–14% in Group I).

Improvement in iron metabolism accompanied the reduction in blood loss: hemoglobin and ferritin levels increased. The combined therapy group also demonstrated more pronounced favorable hormonal changes, including increased progesterone levels and decreased prolactin and cortisol concentrations (p < 0.05), along with a greater reduction in neurovegetative and psychoemotional symptoms.

Conclusions. Combined non-hormonal therapy with the addition of the herbal medicinal product Tazalok to tranexamic acid provides faster and more pronounced control of heavy menstrual bleeding, better restoration of hemoglobin and ferritin levels, favorable neuroendocrine modulation, and greater improvements in neurovegetative and psychoemotional symptoms compared with symptomatic therapy alone.

Author Biographies

T.F. Tatarchuk, SI “Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine»; SSI «Center of Innovative Medical Technologies of the NAS of Ukraine», Kyiv

DSc, professor, corresponding member of the National Academy of Medical Sciences of Ukraine, deputy general director for scientific work, head of the Department of Endocrine Gynecology
chief researcher, Reproductive Health Department

N.V. Kosei, SSI «Center for Innovative Medical Technologies of the NAS of Ukraine»; SI «Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine”, Kyiv

DSc, professor, head of the Department of Reproductive Health
chief researcher, Endocrine Gynecology Department

S.I. Regeda, SSI «Center for Innovative Medical Technologies of the NAS of Ukraine»; SI «Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine», Kyiv

PhD, head of the Gynecological Department
senior researcher, Department of Endocrine Gynecology

L.O. Borisova, SI «Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine», Kyiv; Municipal Non-Profit Enterprise «First Territorial Medical Association of Lviv», Lviv

postgraduate student, Department of Endocrine Gynecology
deputy medical director for maternity and childhood

T.E. Krisenko, SI «Ukrainian Center for Maternity and Childhood of the NAMS of Ukraine»; SI «Heart Institute of the Ministry of Health of Ukraine», Kyiv

postgraduate student, Department of Endocrine Gynecology
obstetrician-gynecologist

R.O. Mnevets, SI “Ukrainian Center of Maternity and Childhood of the National Academy of Medical Sciences of Ukraine»; Educational and Scientific Centre «Institute of Biology and Medicine» of Taras Shevchenko National University of Kyiv, Kyiv

postgraduate student, Department of Endocrine Gynecology
assistant at the Department of Pediatrics, Obstetrics and Gynecology

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Published

2026-04-18

How to Cite

Tatarchuk, T., Kosei, N., Regeda, S., Borisova, L., Krisenko, T., & Mnevets, R. (2026). Abnormal uterine bleeding and hypermenstrual syndrome: new clinical horizons. REPRODUCTIVE ENDOCRINOLOGY, (82), 34–45. https://doi.org/10.18370/2309-4117.2026.82.34-45

Issue

No. 82 (2026)

Section

Gynecology

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