Comparison between Ormeloxifene and Norethisterone in reducing menorrhagia in dysfunctional uterine bleeding
Keywords:Endometrial thickness, Dysfunctional uterine bleeding, Norethisterone, Ormeloxifene, PBAC score
Background: Dysfunctional Uterine Bleeding (DUB) is a condition that affects nearly every woman at some point in her life. This study aims to compare the efficacy of Ormeloxifene and Norethisterone in reducing menorrhagia in such patients.
Methods: This prospective study was done on 100 women presenting with dysfunctional uterine bleeding, of 20-50 years of age, who were ready for follow-up and were allocated into two equal groups, one was given Ormeloxifene and the other was given Norethisterone for a period of 3 months. Haemoglobin levels, endometrial thickness on ultrasound and Pictorial Blood loss Assessment Chart (PBAC) scores were assessed before and after the treatment.
Results: It was found that both Ormeloxifene and Norethisterone reduced menorrhagia, with a significant difference in PBAC scores (p value <0.05). There was a notable reduction in PBAC scores in Ormeloxifene group (66.53% change from pretreatment mean value) as compared to Norethisterone group (31.38% change from pretreatment mean value); and same holds true for the change in haemoglobin levels as well as endometrial thickness. Ormeloxifene was found to have a greater effect on heavy menstrual bleeding in comparison to Norethisterone.
Conclusions: Ormeloxifene is a new modality and is found to be a better option in reducing menorrhagia in DUB in respect to a greater success rate, better compliance and cost effectiveness.
Doshi HU, Kriplani A. Clinical cases in Obstetrics and Gynaecology, 1sted. 2003; 250-251.
Coulter A, Kelland J, Peto V, Rees MC. Treating menorrhagia in primary care: an overview of drug trials and a survey of prescribing practice. Int J Technol Ass Health Care. 1995;11(3):456-71.
Lethaby A, Farquhar C, Cooke I. Antifibrinolytics for heavy menstrual bleeding. Cochrane Database Syst Rev. 2000;(4):CD000249.
V.L. Bhargava. Textbook of Gynaecology ANE Books. 2nd ed 2009;109.
Bouchard P. Current and future medical treatments for menometrorrhagia during the premenopause. Gynecol Endocrinol. 2011; 27(1):1120-5.
Shelly W, Draper MW, Krishnan V, Wong M, Jaffe RB. Selective estrogen receptor modulators: an update on recent clinical findings. Obstet Gynecol Surv. 2008;63(3):163-81.
Samuel NC, Clark TJ. Future research into abnormal uterine bleeding. Best Pract Res Clin Obstet Gynaecol. 2007;21(6):1023-40.
National Collaborating Centre for Women’s and Children’s Health. Heavy menstrual bleeding 2013 Available at https://www.nice.org.uk/guidance/cg132/evidence/full-guideline-pdf-184810861
Mandal D, Parmanik S, Surana S, Hazra A, Mandal S, Maity TK. Comparative study of low-dose oral contraceptive pill and ormeloxifene in the treatment of dysfunctional uterine bleeding. Int J Health Allied Sci. 20143(4);225-31.
Deepika Dhananjayan and Mirunalini et al. Comparative study between ormeloxifene and norethisterone in the improvement of menstrual blood loss (mbl) in abnormal uterine bleeding Int J Current Med Pharmaceut Res. 2016:2;(10):758-61
Agarwal N, Singh S, Singh S, Agarwal M, Manocha P. Comparative evaluation of the efficacy and safety of ormeloxifene and norethisterone in dysfunctional uterine bleeding Int J Reprod Contracept Obstet Gynecol. 2013;2(2);194-8.
Shahab F, Jain S, Jain J, Jain U. Ormeloxifene: Boon to perimenopausal Dysfunctional Uterine Bleeding (DUB) women in avoiding hysterectomies. Int J Med Sci Educat.2014;1(1):21-9.
Kriplani A, Kulshrestha V, Agarwal N. Efficacy and safety of ormiloxefene hcl in management of menorrhagia, A pilot study. J Obst and Gynecol, 2009;35(4):746-52.