Nilofer
SNR District Hospital, Kolar, IndiaPresentation Title:
A comparative study of norethisterone and dydrogesterone in the treatment of heavy menstrual bleeding
Abstract
Background: HMB is described as bleeding for >7 days or >80 ml per cycle/ having a higher than 100 score on the pictorial blood assessment chart (PBAC). Medical management is the first line of treatment. Norethisterone is the most commonly used oral progestin. Dydrogestrone is a C-21 derivative that is a highly selective synthetic progestin, closely related to endogenous progesterone.
Methods: The 170 cases of heavy menstrual bleeding (HMB) with ovulatory disorder in the range of 20-45 years of age were assigned into two groups (85women in each group). Group A received Norethisterone 10 mg and Group B received Dydrogesterone 10mg twice daily, respectively, till bleeding stopped. The same dose was continued for another week and then 10 mg OD for one week till 28 days of LMP, whichever was later. Both groups were followed up for another 3 cycles and responses to treatment were analysed using the PBAC score and Hb levels before and after treatment.
Results: A significant decrease in PBAC score and improvement in haemoglobin level were observed in both the groups, i.e., 82.35% women in the Norethisterone group and 78.82% in the Dydrogesterone group, respectively. In the Norethisterone group, 3.53% and 7.08% women in the Dydrogesterone group underwent hysterectomy, whereas 5.9% women in the Norethisterone and 4.7% in the Dydrogesterone group opted for therapeutic dilatation curettage, respectively.
Conclusions: Dydrogesterone is as effective as Norethisterone in controlling heavy menstrual bleeding. Dydrogesterone can be considered as a safer and efficacious alternative to Norethisterone given its highly selective nature and the absence of androgenic side effects.
Biography
Nilofer is a postgraduate student from the department of OBGYN at SNR District Hospital, Kolar, Karnataka, India.
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