Supplemental figuresMedical management of heavy menstrual bleeding: a comprehensive review of the literature

Johannes Bitzer, MD, PhD,1 Oskari Heikinheimo, MD, PhD,2 Anita L. Nelson, MD,3 Joaquin Calaf-Alsina, MD, PhD,4 Ian S. Fraser, MD, DSc5

1Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland; 2Department of Obstetrics and Gynaecology,

Kätilöopisto Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; 3Los Angeles BioMedical Research Institute

at Harbor-UCLA Medical Center, Torrance, CA USA; 4Department of Obstetrics and Gynaecology, Hospital de la Santa Creu i Sant Pau, Universitat

Autónoma, Barcelona, Spain; 5University of Sydney, Sydney, New South Wales, Australia

Corresponding author: Ian Fraser, Department of Obstetrics and Gynaecology, Central Clinical School, D02–QEII Research Institute for Mothers

and Infants, The University of Sydney, Sydney, NSW 2006, Australia. Phone: +61 2 9351 2478; Fax: +61 2 9351 4560; E-mail:

ian.fraser@sydney.edu.au

Supplemental Figure 1. Summary of the distribution of reported reductions in menstrual blood loss (MBL) in women with HMB due to endometrial dysfunction (AUB-E) treated with the levonorgestrel-releasing intrauterine system (LNG-IUS): mean reductions reported by alkaline hematin (a) and pictorial blood assessment chart scores [PBAC] (b), and median reductions reported by alkaline hematin (c) and PBAC scores (d). Each circle represents data from a single study and the line represent the average trend at a given time point (1-27).

b)a)

c) d)

Supplemental Figure 2. Summary of the distribution of reported mean reductions in pictorial blood assessment chart scores [PBAC] in women HMB due to endometrial dysfunction (AUB-E) (a) or leiomyomas (AUB-L) (b) treated with the levonorgestrel-releasing intrauterine system (LNG-IUS). Each circle represents data from a single study and the line represent the average trend at a given time point (1, 4-6, 8, 9, 11-13, 15-17, 21, 23-25, 27-33).

b)a)

Supplemental Figure 3. Summary of the distribution of reported mean reductions in menstrual blood loss (MBL) in women with HMB due to

endometrial dysfunction (AUB-E) following treatment with, a) the levonorgestrel-releasing intrauterine system (LNG-IUS), b) tranexamic acid

[includes data from Andersch et al 1988 where patients received tranexamic acid 1.5 mg TID on days 1 to 3 followed by 1 g BID for another two days

(34)], c) danazol, and d) non-steroidal anti-inflammatory drugs (NSAIDs). Each circle represents data from a single study and the line represent the

average trend at a given time point (3, 14, 16, 19, 20, 22, 34-46).

b)a)

c) d)

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