Norethisterone Versus Levonorgestrel Intrauterine System in Heavy Menstrual Bleeding: Randomised Open Labelled Clinical Trial

Abstract

Introduction: Within the United States, any abnormal pattern of bleeding from a wide range of causes, such as anovulation, pregnancy, uterine disease, and coagulopathies, is referred to as "ABNORMAL UTERINE BLEEDING" (AUB). Any departure from the typical menstrual pattern in terms of regularity, frequency, volume, or length of flow is what is meant by this definition.

Aims: To evaluate the effectiveness of LNG-IUS versus norethisterone in treating severe menstrual bleeding in terms of: Menstrual cycle time on average and PBAC/PABC score

Materials and method: The present study Randomised open labelled clinical trial. This Study was conducted from March 2017 – February 2018 at Dept. of bstetrics and gynecology in EDEN hospital in Medical college and hospital, Kolkata. Total 66 patients were included in this study.

Result: The mean haemoglobin concentration in group N was 9.40 % which increased to 9.41% after three months of treatment. The increase in mean haemoglobin concentration was only 0.1%. The p-value thus obtained was 2.028×10-21 (<0.05) which is statistically significant. The mean haemoglobin concentration in Group L was 9.21% before treatment was initiated, which increased to 9.45% after three months of insertion of LNG-IUS. The increase in mean haemoglobin concentration was 2.53%.

Conclusion: In addition to its clinical costs, heavy menstrual bleeding has significant social and economic repercussions. LNG-IUS and tablet norethisterone are secure and efficient ways to manage HMB. We find that while both LNG-IUS and Norethisterone are useful in treating excessive menstrual bleeding, LNG-IUS is more successful in reducing the incidence of hysterectomy and improving dysmenorrhea, as well as improving endometrial thickness, average menstrual cycle duration, and PABC score.