Title: Comparative study of effectiveness of Ormeloxifene and Medroxy Progesterone Acetate in the management of Dysfunctional Uterine Bleeding
Authors: Dr S. Manjula, MD., Dr G. Ambujam, MS., Dr Alla Satyanarayana Reddy, MD.
DOI: https://dx.doi.org/10.18535/jmscr/v8i5.79
Abstract
Abnormal uterine bleeding without any systemic or local structural causes was earlier termed dysfunctional uterine bleeding. It is nearly equivalent to COE of the new FIGO classification of AUB. Ormeloxifene is a non steroidal, nonhormonal, selective receptor modulator inhibitor, widely used as an oral contraceptive. In the past decade, Ormeloxifene was well established in the control of menorrhagia. This is a prospective, randomised, comparative study of the efficacy of Ormeloxifene and Medroxy Progesterone Acetate (MPA) in the control of bleeding in DUB. A group of sixty women, had Ormeloxifene 60 mg twice a week for 12 weeks and once a week for a further 12 weeks. Another group of sixty women, had MPA 20 mg a day cyclically for 21/28 days for six months. Hb level, endometrial thickness and PBAC score are the parameters analysed. In both groups, there is a significant improvement in Hb level. In control of bleeding, the action of Ormeloxifene is seen in a month and the benefit continued throughout the treatment. With MPA, the control of bleeding is not satisfactory in the first cycle, but from second cycle, there is satisfactory control of bleeding, slightly less than that of Ormeloxifene. During the course of treatment, 1/4th of women in Ormeloxifene group and 1/8 th of women MPA group became amenorrhic.
Keywords: AUB; DUB; Menorrhagia; Ormeloxifene; Medroxy progesterone acetate.
References
- Munro MG, Critchley HO, Broder MS, et al. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in non gravid women of reproductive age. FIGO Working Group on Menstrual Disorders. Int J Gynaecol Obstet. 2011;113:3–13.
- Awwad JT, Toth TL, Schiff I. Abnormal uterine bleeding in the perimenopause. Int J Fertil. 1993;38:261
- Kumar GR, Rituraj K, Hemant BK, Singh MM. The in-vitro anti-cancer breast activity of ormeloxifene is mediated via the induction of apoptosis and autophagy. 37th Annual Conference of the Endocrine Society of India.30 Nov-2 Dec, 2007. Abstract p35
- Singh MM. “Centchroman, a selective estrogen receptor modulator, as a contraceptive and for the management of hormone-related clinical disorders”. Medicinal Research Reviews. 2001; 21 (4): 302–47
- Kriplani A, Kulshrestha V, Agarwal N. Efficacy and safety of ormeloxifene in management of menorrhagia: a pilot study. J Obstet Gynaecol Res. 2009;35:746–52.
- Studd J. Progress in obstetrics and gynecology. In: Current minimal access techniques for dysfunctional uterine bleeding. Churchill Living Stone, 2003; 15: 259-272.
- Jacob KJ, Mini, Deepak AV. A comparative study on the effectiveness of ormeloxifene versus norethisterone in the management of perimenopausal dysfunc-tional uterine bleeding. IAIM, 2015; 2(7): 87-92.
- Chhatrala JJ et al. Int J Reprod Contracept Obstet Gynecol. 2015 Apr;4(2):366-369
- Ravibabu Komaram et al., A Study of Efficacy of Ormeloxifene in the Pharmacological Management of Dysfunctional Uterine Bleeding Journal of Clinical and Diagnostic Research. 2013 Nov, Vol-7(11): 2534-2536
- Singh HO, Singh A, Dhole TN, Nain S (2015) Effect of Ormeloxifene for Management of Dysfunctional Uterine Bleeding. Biochem Physiol 4: 174. doi: 10.4172/2168-9652.1000174
- Godha et al. The Journal of Obstetrics and Gynecology of India (September–October 2016) 66(S1):S395–S399.