**5. Non-steroidal anti-inflammatory drugs**

Non-steroidal anti-inflammatory drugs reduce the levels of prostaglandins that may be elevated in cases of menorrhagia and dysmenorrhea.

In a metanalysis of nine randomized controled trials, where 759 women were included in the review, prostaglandins were higher in women with heavy menstrual bleeding and were reduced by the administration of non-steroidal anti-inflammatory drugs that were modestly effective compared to tranexamic acid, danazol, and levonorgestrel-releasing intrauterine system (LNG IUS). Those findings were based on a limited number of low- to moderate-quality trials [7].

Similar conclusions were made by a study of published Cochrane Reviews on heavy menstrual bleeding interventions in the Cochrane Database of Systematic Reviews [8].
