Comparison of the efficacy and safety of norethisterone vs combined oral contraceptive pills for the management of puberty menorrhagia

Patel, Nita; Patel, Shalin; Damor, Rohit; Pandya, Manish R

doi:10.5455/2319-2003.ijbcp003512

Cited by 5 publications

(5 citation statements)

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“…Nita K Patel et al in their comparative study showed that the use of norethisterone for the management of puberty menorrhagia was more effective and better tolerated compared with oral contraceptive pills [23].…”

Section: Discussionmentioning

confidence: 99%

Gynecological Problems of Adolescent Girls Attending Outpatient Department at Tertiary Care Center with Evaluation of Cases of Puberty Menorrhagia Requiring Hospitalization

Rathod

Chavan

Pajai

et al. 2015

J Obstet Gynecol India

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Adolescence is a period of enormous physical and psychological change for young girls. Many adolescents with menstrual disturbances never present to their family doctor or gynecologist. Embarrassment about discussing menstruation, fear of disease, and ignorance about services available may lead to delayed presentation or consultation with doctor. Aims and Objective(1) To evaluate the different gynecological problems in adolescent girls attending outpatient department. (2) To evaluate the prevalence of severe anemia requiring indoor admission in adolescent girls with puberty menorrhagia. (3) To assess the etiologies of puberty menorrhagia.Result There were a total of 655 adolescent girls attending the gynecology OPD during the study period. Menstrual complaints (84.88 %) were the commonest indication for OPD consultation among adolescent girls. 17 girls required hospitalization; all of them needed blood transfusion due to significant severe anemia resulting from puberty menorrhagia. 14 (82.35 %) had anovulatory DUB, (2002) from the Government Medical College, Nagpur. She presented a poster at AMOGS 2012 at Nanded, which was selected among the best six posters of the conference, and also a poster at the World Congress of Dilemma in Pregnancy at Nagpur in 2013. She had presented a paper on ''Analysis of near-miss cases and maternal mortality'' at SVN GMC, Yavatmal at the AICOG 2015 in Chennai and chaired a session at the AICOG 2015. She has to her credit three papers published in national and international journals, and several articles are under review. She is a MUHS-recognized teacher and MMC-accredited speaker. She is interested in studying health problems of women and girls in rural and tribal districts of Yavatmal. Her other areas of interest are high-risk pregnancy and adolescent health.The Journal of Obstetrics and Gynecology of India (September-October 2016) 66(S1):S400-S406 DOI 10.1007/s13224-015-0770-1 123 while 2 (11.76 %) had coagulation disorders, and one (5.88 %) had hypothyroidism. Conclusion Adolescent girls with menorrhagia need to be evaluated thoroughly earlier rather than later so that effective management can be started and severe anemia with its consequences can be avoided. Adolescent health education and group discussion is needed to create awareness regarding adolscent gynecological problems; it should be conducted regularly in schools and colleges.

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Section: Discussionmentioning

confidence: 99%

Gynecological Problems of Adolescent Girls Attending Outpatient Department at Tertiary Care Center with Evaluation of Cases of Puberty Menorrhagia Requiring Hospitalization

Rathod

Chavan

Pajai

et al. 2015

J Obstet Gynecol India

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“…18 Norethisterone is reported to be more effective and better tolerated in the management of puberty menorrhagia as compared to combined oral contraceptive pills. 19 In our study, styptic action was noted in ≤4 hours for the majority of the study population. Studies have shown that as compared to oral norethisterone, the levonorgestrelcontaining intrauterine device (IUD) is better for the treatment of chronic AUB.…”

Section: Discussionmentioning

confidence: 46%

Real-world Safety and Effectiveness Analysis of Norethisterone in the Management of Abnormal Uterine Bleeding

Jaiswal¹,

Boruah²,

Jaiswal³

et al. 2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective: To assess the real-world safety and effectiveness of norethisterone 10 mg-controlled release (CR) formulation in the management of abnormal uterine bleeding (AUB). Methods: This was a retrospective analysis of real-world data collected between January 2021 and March 2021 across 40 centers in India. A total of 308 women in the reproductive age-group (18-45 years) with ovulatory AUB were treated with norethisterone CR 10 mg once a day for 10 days. The data from women with a confirmed diagnosis of AUB were included in the study. The clinical records that were analyzed for the primary objectives included the time required for arresting heavy menstrual bleeding after initiating medication, the incidence of breakthrough bleeding, safety and tolerability, and the secondary objectives included the timing of withdrawal bleeding after the last tablet was taken, assessment of heaviness of bleeding, and treatment compliance. Results:The mean age [± standard deviation (SD)] was 33.8 ± 8.3 years. Out of the 308 women with AUB, the majority of women (n = 193, 63%) experienced styptic action of norethisterone 10 mg CR within 4 hours of administration of the medication, 61% of the women (n = 187) did not report any incidence of breakthrough bleeding, and 70% of the women (n = 216) reported withdrawal bleeding within 24-72 hours of administration of the last medication dose. No adverse events were reported. Heavy bleeding was noted in only 7% of the women. More than 80% of compliance with therapy was observed in 94% of women (n = 290). Conclusion: Our analyses of the retrospective data suggested that norethisterone 10 mg CR was safe and effective for the treatment of AUB in Indian women. Clinical significance: To the best of our knowledge, this is the first real-world study to show that norethisterone 10 mg CR effectively treats AUB, is safe, and is associated with a high compliance rate in Indian women of reproductive age-group (18-45 years).

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“…Following the withdrawal bleeding combined oral contraceptive pills were started from the D5 of withdrawal flow and continued for 21 days for 3 cycles. Patel et al [19], also used similar regimen of hormonal therapy in his study. In patients with severe bleeding associated with hemodynamic changes blood transfusions are indicated with administration of intravenous conjugated equine estrogen, 25 mg I/V every 4 hours for up to 24 hours.…”

Section: Discussionmentioning

confidence: 95%

Evaluation of etiological factors and management of puberty menorrhagia

Deo

Agrawal

Sankhwar

et al. 2018

Int Jour of Biomed Res

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Objectives: To evaluate the causes of puberty menorrhagia and effect of hormonal (Progestogens, estrogens and Combined Oral Contraceptive pills) and non-hormonal methods in the management of puberty menorrhagia.Methods: This prospective study included 51 subjects, who presented with puberty menorrhagia to Department of Obstetrics and Gynaecology, King George Medical University, Lucknow from August 2014 to August 2015. Assessment of each case with thorough history, physical examination and laboratory investigations was done. The underlying cause was diagnosed and the relevant treatment started and subjects kept under regular follow up.Results: In 26 (50.98%) subjects, immaturity of hypothalamic pituitary ovarian axis was the main cause of pubertymenorrhagia, 6 (11.76%) subjects had hypothroidism,5 (9.80%) subjects had polycystic ovarian syndrome, 4 (7.8%) subjects had idiopathic thrombocytopenic purpura, 2 (3.9%) subjects had disseminated intravascular coagulopathy, 3 (5.88%) subjects had hyperprolactinemia, 3 (5.88%) subjects had both hypothyroidism and hyperprolactinemia, 2(3.92%) subjects had fibroid uterus. All patients responded to medical management.Conclusion: Puberty menorrhagia is a distressing condition both for the subject as well as her parents. Most of thecases are due to anovulatory cycles which is a self-limiting condition at perimenarchal age group. Counseling and reassurance ofthe subjects is an important part of management. Long term medical treatment is successful in the majority of cases and rarely surgical intervention is required. Blood transfusion is required in a few cases.

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Comparison of the efficacy and safety of norethisterone vs combined oral contraceptive pills for the management of puberty menorrhagia

Cited by 5 publications

References 18 publications

Gynecological Problems of Adolescent Girls Attending Outpatient Department at Tertiary Care Center with Evaluation of Cases of Puberty Menorrhagia Requiring Hospitalization

Gynecological Problems of Adolescent Girls Attending Outpatient Department at Tertiary Care Center with Evaluation of Cases of Puberty Menorrhagia Requiring Hospitalization

Real-world Safety and Effectiveness Analysis of Norethisterone in the Management of Abnormal Uterine Bleeding

Evaluation of etiological factors and management of puberty menorrhagia

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