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SOCRATES 9 (Synopsis of Cochrane Reviews applicable to Emergency Services)
  1. P Gilligan1,
  2. D Hegarty2,
  3. A Khan1,
  4. M Shepherd1,
  5. G Lumsden1,
  6. G Kitching1,
  7. A Taylor1,
  8. H Law1,
  9. J Brenchley1,
  10. J Jones1
  1. 1Specialist Registrars in Emergency Medicine on the Yorkshire Rotation
  2. 2General Practitioner, Leeds, UK
  1. Correspondence to:
 Dr P Gilligan
 1 Far Moss, Alwoodley, Leeds, Yorkshire LS17 7NU, UK;

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In this the ninth article of the SOCRATES series we present our synopses of reviews from the Cochrane Database of Systematic Reviews relating to obstetrics and gynaecology that the working party felt were of particular relevance to emergency medicine practitioners. The methods of our review and the rationale for the forming the SOCRATES working party are as have previously been published.



Non-steroidal anti-inflammatory drugs (NSAIDs) reduce elevated prostaglandin levels in women with excessive menstrual bleeding and may also ease dysmenorrhoea.


Nine trials with a total of 377 women were pooled for meta-analysis. A further seven trials with 99 participants in total were identified but could not be included in the meta-analysis as a result of their crossover design. The trials were not of consistently high quality. NSAIDs (naproxen or mefenamic acid) were equally more effective than placebo but inferior to danazol or tranexamic acid. Danazol had more significant side effects.


From the limited data available NSAIDs appear to be effective and well tolerated when used for the reduction of heavy menstrual bleeding.



About 50 million pregnancies are terminated …

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  • Competing interests: none declared