Dysfunctional uterine bleeding: ormeloxifene versus combined oral contraceptive pills


  • Sonia Luthra Department of Obstetrics and Gynecology, Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India
  • A. D. Dwivedi Department of Obstetrics and Gynecology, Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India




Dysfunctional uterine bleeding, Oral contraceptive pills, Ormeloxifene, Selective estrogen receptor modulator


Background: Dysfunctional uterine bleeding is abnormal bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy.  Globally, health care systems are focusing on low morbidity and low cost therapeutic interventions. Hence, medical treatment for DUB is high on the priority list. This comparative study was conducted to analyse the efficacy of ormeloxifene and combined oral contraceptive pills in reducing the blood loss and endometrial thickness in cases of DUB.

Methods: This prospective study was conducted on women with dysfunctional uterine bleeding, who attended Gynaecology OPD at Hind Institute of Medical Sciences, between August 2015 and April 2016. After applying inclusion and exclusion criteria, 72 women diagnosed with DUB were enrolled randomly in two groups A and B. Group A was treated by Ormeloxifene and Group B patients were treated with combined oral contraceptive pills for three consecutive cycles. The efficacies of the studied drugs were compared by analyzing the mean change in the pre and post treatment PBAC score, haemoglobin level and endometrial thickness using unpaired t-test.

Results: Ormeloxifene was found to be significantly more effective (p <0.0001) than OCPs in controlling the menstrual blood loss (79% reduction in group A Vs 55.5% reduction in group B). Reduction in endometrial thickness was also more in the group receiving Ormrloxifene, however this was statistically not significant (p = 0.19). No major side effect observed with the use of Ormeloxifene.

Conclusions: Ormeloxifene can be an effective and safe therapy in the treatment of Dysfunctional uterine bleeding.


Singh S, Best C, Dunn S, Leyland N, Wolfman WL, Wolfman W, et al. Abnormal uterine bleeding in pre-menopausal women. J Obstet Gynaecol Canada. 2013;35(5):473-5.

Bennett AR, Gray SH. What to do when she’s bleeding through: the recognition, evaluation, and management of abnormal uterine bleeding in adolescents. Current Opin Pediat. 2014;26(4):413-9.

Rezk M, Masood A, Dawood R. Perimenopausal bleeding: Patterns, pathology, response to progestins and clinical outcome. J Obstet Gynaecol. 2015;35(5):517-21.

Khrouf M, Terras K. Diagnosis and management of formerly called “dysfunctional uterine bleeding” according to PALM-COEIN FIGO classification and the new guidelines. J Obst Gynecol India. 2014;64(6):388-93.

Abid M, Hashmi AA, Malik B, Haroon S, Faridi N, Edhi MM, et al. Clinical pattern and spectrum of endometrial pathologies in patients with abnormal uterine bleeding in Pakistan: need to adopt a more conservative approach to treatment. BMC Women's Health. 2014;14(1):132.

Biswas SC, Saha SK, Bag TS, Ghosh Roy SC, Roy AC, Kabiraj SP. Ormeloxifene: A selective estrogen receptor modulator for treatment of dysfunctional menorrhagia. J Obstet Gynecol Ind. 2004;54(1):56-59.

ACOG practice bulletin selective oestrogen receptor modulators. Clinical management guidelines for Obstetricians Gynecologists 2002;39(4):835-44.

Shelly W, Draper MW, Krishnan V, Wong M, Foffe RB. The selective oestrogen receptor modulators: An update on recent clinical findings. Obstet Gynecol Survey. 2008;63(3):163-81.

Tejwani PL, Srivastava A, Nerkar H, Dhar A, Hari S, Thulkar S, et al. Centchroman regresses mastalgia: a randomized comparison with danazol. Indian J Surg. 2011;73(3):199-205.

Higham JM, O'brien PM, Shaw R. Assessment of menstrual blood loss using a pictorial chart. BJOG: Int J Obstet Gynaecol. 1990;97(8):734-9.

Kriplani A, Kulshrestha V, Agarwal N. Efficacy and safety of ormeloxifene in management of menorrhagia: a pilot study. J Obstet Gynaecol Res. 2009;35(4):746-52.

Shravage J, Mekhala D, Bellad MB, Ganachari MS, Dhumale HA. Ormeloxifene versus Medroxyprogesterone Acetate (MPA) in the treatment of Dysfunctional Uterine Bleeding: A double-blind randomized controlled trial. J South Asian Fed Obstet Gynecol. 2011;3(1):21-4.

Dhananjay BS, Nanda SK. The role of sevista in the management of dysfunctional uterine bleeding. J Clin Diag Res: JCDR. 2013;7(1):132.

Agarwal N, Singh S. The efficacy and safety of ormeloxifene in dysfunctional uterine bleeding. Age (years). 2013;32:20-50.






Original Research Articles