Medical management of dysfunctional uterine bleeding

Irvine, G A; Cameron, Iain

doi:10.1053/beog.1999.0017

Cited by 46 publications

(24 citation statements)

References 57 publications

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“…Medical treatment of menorrhagia should aim to relieve symptoms, improve quality of life and avoid the risk of surgery. Many women remain menorrhagia despite decrease in menstrual blood loss by 50% with treatment with tranexamic acid, mefenemic acid, norethisterone or ethamsylate 3,4 and non-compliant due to daily dosing or their side-effects. Basis for weekly dosing schedule of Ormeloxifene are the long elimination half-life and a long lasting estrogen antagonist action.…”

Section: Discussionmentioning

confidence: 99%

To Study the Effect of Ormeloxifene in Management of Perimenopausal Dysfunctional Uterine Bleeding

Anjum¹,

Agrawal²,

Kulshreshtha³

et al. 2015

jemds

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OBJECTIVE:To study the effect of ormeloxifene in dysfunctional uterine bleeding in premenopausal age group by measuring menstrual blood loss by PBAC score, effect on blood hemoglobin levels and effect on endometrial thickness. METHODS: 35 cases of DUB of age 40 years and above coming to Gynecological OPD were recruited for study after applying exclusion criteria. 60 mg of Ormeloxifene was given twice a week for 3 months and then once a week for 1 month. Patients were followed-up at 1, 3 and 4 months of therapy and then at 3 months after treatment stopped. Menstrual blood loss was measured objectively by pictorial blood loss assessment chart (PBAC) score. RESULTS: The pretreatment median PBAC score was 587 with a range of 186-893. After 4 months of treatment, mean PBAC scores reduced to 76.94±77.73 with a mean change of 490.05±155.4. Which is statistically highly significant (P0.001). 26 (81.25%) patients were cured of menorrhagia at the end of 4 months of treatment. 2 patients had no response and underwent hysterectomy. Amenorrhoea occurred in 22 patients at the end of 4 months of therapy and persisted in 18 patients at 3 months of follow-up after therapy while 1 patient had PBAC scores in the heavy range but much less than her pretreatment levels. Adverse effects included vaginal discharge (15.62%), vague abdominal pain (12.5%), gastric upset (6.25%), headache (6.25%) and ovarian cyst (3.12%). CONCLUSION: Ormeloxifene is an effective and safe therapeutic option for the medical management of perimenopausal DUB.

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Section: Discussionmentioning

confidence: 99%

To Study the Effect of Ormeloxifene in Management of Perimenopausal Dysfunctional Uterine Bleeding

Anjum¹,

Agrawal²,

Kulshreshtha³

et al. 2015

jemds

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“…The combined oral contraceptive pill and the levonorgestrel intrauterine system give reductions of 50% and 80% in MBL, with an additional contraceptive cover. Cyclical progestogens are the most commonly prescribed therapy in the United Kingdom, but they are ineffective for the management of ovulatory menorrhagia unless they are taken at high doses (10-15mg daily) for 3 weeks out of [4,11].…”

Section: Methodsmentioning

confidence: 99%

The Role of Sevista in the Management of Dysfunctional Uterine Bleeding

BS¹

2013

JCDR

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Objective: The complaints of excessive menstrual bleeding (menorrhagia) have a substantial impact on the gynaecological services and in most of the cases, no organic pathology is identified. Nonsteroidal anti-inflammatory drugs and tranexamic acid offer a simple therapy which has to be taken during menses, with reductions of 25-35% and 50% respectively in the Menstrual Blood Loss (MBL). Danazol and the gonadatrophin-releasing hormone analogues are highly effective, but their side-effects make them suitable only for a short-term use. In the present study, the role of ormeloxifene was studied in patients of DUB. Materials & Methods:The subjects were diagnosed cases of DUB. After ruling out the possible causes of the abnormal uterine

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“…7 Ormeloxifene was found to be more effective than progesterogens in the management of menorrhagia. 8,9 Progesterogens are ineffective in the treatment of ovulatory DUB. 10 Ormeloxifene is a good option in DUB, because it is a SERM (Selective Estrogen Receptor Modulator) which acts as an estrogen antagonist on uterus and breast, but acts as a mild agonist on vagina, bone, central nervous system and serum lipids.…”

Section: Introductionmentioning

confidence: 99%

Reduced Dose of Ormeloxifene in Dysfuncitonal Uterine Bleeding-Safety and Effectiveness

Suhasini¹,

Lakshmi²,

Padma³

et al. 2016

jemds

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AIM OF THE STUDYTo evaluate the effectiveness and safety of reduced dose of Ormeloxifene in the management of Dysfunctional Uterine Bleeding (DUB). Long term medical management for DUB, which is ideal and cost-effective is not yet available. Once it is available, it can revolutionise the management of DUB in developing countries. If Ormeloxifene is proved to be effective long-term at lower doses with minimal side effects, it can prevent the major number of blood transfusions and hysterectomies, which are common especially in the lower socioeconomic group of patients who cannot afford costly conservative measures. MATERIAL AND METHODSOut of 240 eligible patients with DUB, recruited from Gynaec OPD of CKM Hospital, Warangal, only 160 women consented to participate, out of which half of the patients were given the standard dose of Ormeloxifene that is 60mg twice a week for 3 months and once a week for 3 months (Group A). Half of the patients were given reduced dose of Ormeloxifene that is 30mg twice a week for all 6 months (Group B); 54 women from each group who completed the 6 months treatment and came regularly for followup were included in the present study. Both groups were matched for age and parity.Pre-treatment PBAC (Pictorial Blood Loss Assessment Chart) scores were done for all cases and mean PBAC scores were calculated. Same was done at follow-up visits at 1 month, 3 months and 6 months. Side effects were looked for and TVS was done for Endometrial Thickness (ET)/Ovarian cysts. Haemoglobin estimation was done at the end of the study. Effectiveness was taken as reduction of mean PBAC score at the end of 6 months. CONCLUSIONMean PBAC scores at the end of 6 months, in each group showed a reduction of 86.64% of blood loss in group A (standard dose of Ormeloxifene) and 87.69% of blood loss in group B (reduced dose of Ormeloxifene). The reduction in both groups was similar. When the reduction in group A and group B was compared, the difference was not statistically significant [P = 0.33]. Hence, the lower dose schedule followed in group B can be recommended for management of DUB. This could make long term usage of Ormeloxifene more feasible when proved safe by larger randomised double blind studies.

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Medical management of dysfunctional uterine bleeding

Cited by 46 publications

References 57 publications

To Study the Effect of Ormeloxifene in Management of Perimenopausal Dysfunctional Uterine Bleeding

To Study the Effect of Ormeloxifene in Management of Perimenopausal Dysfunctional Uterine Bleeding

The Role of Sevista in the Management of Dysfunctional Uterine Bleeding

Reduced Dose of Ormeloxifene in Dysfuncitonal Uterine Bleeding-Safety and Effectiveness

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