Management Of Dysfunctional Uterine Bleeding Research Articles

Transarterial embolization of uterine arteries in emerging dysfunctional uterine bleeding: a single-center case series study

BackgroundUterine artery embolization is proven to be an effective treatment for symptomatic uterine fibroids. Yet, its role in the management of dysfunctional uterine bleeding is still debatable. Patients with dysfunctional uterine bleeding have abnormal bleeding from the uterine vascular bed with variable underlying mechanisms. Uterine artery embolization will reduce/prevent bleeding by occlusion of the vascular bed, with subsequent cutoff of the effect of hormones on the endometrium. The aim of this work is to demonstrate the safety, efficacy and possible short-term complications of uterine artery embolization in the treatment of dysfunctional uterine bleeding (DUB) as a first-line treatment modality rather than the current treatment options (hormonal and surgical treatment).MethodsThirty patients included in the study were clinically and laboratory diagnosed based on FIGO classification system (PALM-COEIN) as DUB, and the diagnosis was confirmed by MRI imaging. All patients were subjected to transcatheter uterine artery embolization with subsequent clinical and radiological follow-up to assess the treatment outcome.ResultsUterine artery embolization was able to control bleeding in patients diagnosed as DUB, with subsequent complete cessation of medical treatment; no surgical interference was needed with much less morbidity. We had 93.3% improvement in the frequency, volume of bleeding and 100% improvement of the presenting anemia. No significant change in uterine volume or in endometrial thickness has been noted.ConclusionsUterine artery embolization is safe, effective procedure to control dysfunctional uterine bleeding with the preservation of the uterus especially in critical age groups.

A Comparative Study on Efficacy of Norethisterone and Medroxyprogestrone in the Management of Dysfunctional Uterine Bleeding: A Prospective Observational Study

Dysfunctional uterine bleeding (DUB) is defined as bleeding from the uterine corpus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy. Methylprogesterone (MPA) and Norethisterone (NE) are a sort of female hormone (progestin).To cure dysfunctional uterine bleeding, this study sought to determine how MPA and NE worked. Materials and Procedures Over three months, a prospective observational study was conducted at a hospital in Palakkad. The usefulness of MPA and NE is analyzed by using the PBAC score method. Using Microsoft Excel 2007, the cases were entered, and descriptive statistical analysis was then performed. Results and Discussion There were 71 respondents in this study, with ages ranging from 18 to 35 and older. 32 of the 71 people received MPA, whereas 39 of them acquired NE. DUB was much more prevalent in women over 35 (NE-56.4% and MPA-75%). DUB is usually seen in overweight individuals (NE: 56.4%; MPA: 50.). The PBAC score dropped after both medications were administered. Norethisterone is more effective than either of the drugs, as per this study.

A Clinical Study to Evaluate Efficacy of KVGAP’S Femicare Syrup on Raktapradara w.s.r to Dysfunctional Uterine Bleeding

Dysfunctional uterine bleeding (Raktapradara) is the commonest gynaecological disorder affecting the quality women’s life of reproductive age group. A clinical study was conducted with KVGAP’S Femicare Syrup on 28 patients of DUB. KVGAP’S Femicare syrup is a polyherbal Ayurvedic formulation prepared from ingredients like Ashoka, Ashwagandha, Gokshura, Guduchi, Shatavari, Manjhistha, Usheera, Kumari, Sariva, Pippali, and Shilajathu. The parameters assessed were number of bleeding episodes, excessive bleeding, investigators global assessment scale, VAS for pain, participants overall assessment scale, clot and interval (number of days of the cycle). Patients were assessed at the beginning of the trail, after 1 month and after 2 months. 56.52%, 73.08%, 77.6%, 85%, 81.93%, 100% improvement were observed in the clinical parameters assessed (number of bleeding episodes, excessive bleeding, investigators global assessment scale, VAS for pain, participants overall assessment scale, clot) respectively. Results were statistically significant. Interval didn’t show any changes. Out of 28 patients in this study, 1 patient shown mild improvement, 11 patients (39%) were shown moderate improvement and 16 patients (57%) had marked improvement. Overall effect of the treatment was 77.31%. This study showed that KVGAP’S Femicare syrup showed promising results in treating DUB. Hence it can be concluded that KVGAP’S Femicare Syrup is effective and safe in the management of dysfunctional uterine bleeding.

Role of Antimicrobials in management of Dysfunctional Uterine Bleeding in Premenopausal Women

Role of Antimicrobials in management of Dysfunctional Uterine Bleeding in Premenopausal Women

A Comparative Study of Tranexamic Acid and Ethamsylate in Dysfunctional Uterine Bleeding

Abstract: Background: Dysfunctional Uterine Bleeding is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease or pregnancy. Bleeding may be excessively heavy or light and may be prolonged, frequent or random. About 1-2% of women with improperly managed an ovulatory bleeding eventually may develop endometrium cancer. There is less evidence which states the effectiveness of both the drugs because of which this study has been performed. Aim and Objectives: The objective of the study was to compare the efficacy of tranexamic acid and ethamsylate and to study the reduction in heavy menstrual bleeding. Materials and Methods: This study is a prospective comparative study which was conducted at Employee State Insurance Hospital, Ayanavaram, and Chennai. Of 56 patients recruited for the study with randomisation, 28 patients were in group A (tranexamic acid) and 28 patients were in group B (ethamsylate). Four patients were lost for follow up and two patients discontinued the given drugs. Hence 50 patients were included in the study. Group A received Tranexamic acid 500mg, BD, from 1 to 5 days of the menstruation for three consecutive cycles. Similarly Group B received Ethamsylate 500mg, BD from 1 to 5 days of the menstruation for three consecutive cycles. Results: Female patients between the age group of 39-45 years are mostly affected with dysfunctional uterine bleeding (DUB). PBAC mean score showed a significant reduction in menstrual blood loss both with tranexamic acid (293.84± 137.50) and ethamsylate (326.24±83.89), but tranexamic acid proved to be more efficacious. Hb level in tranexamic acid (12.96± 0.99) group was seen to be increased slightly when compared with ethamsylate group (12.024±1.07). The Endometrium thickness of the patients receiving tranexamic acid (3.404± 0.99) was between the normal ranges. Use of tranexamic acid and ethamsylate improved health-related quality of life. Conclusion: This study suggests that both tranexamic acid and ethamsylate are effective in management of dysfunctional uterine bleeding. Tranexamic acid was superior to ethamsylate in terms of effectiveness, reduction in blood loss and improvement in quality of life. Key words: Dysfunctional uterine bleeding, Endometrium thickness, Tranexamic acid, Ethamsylate, Menstruation.

ROLE OF NASYA IN THE MANAGEMENT OF DYSFUNCTIONAL UTERINE BLEEDING - A REVIEW

Regular menstrual cycles with adequate quantity and duration of bleeding indicate good reproductive health, with variations in these being reflected as menorohagia, oligomenorrbea, dysmenorrbea, PCOD, infertility etc. Dysfunctional uterine bleeding is particularly common during adolescence and perimenopausal periods. It has been defined as a state of excessive uterine bleeding without clinically detectable organic, systemic and iatrogenic causes. DUB is caused by the abnormal functioning of hypothalamo – pituitary – ovarian axis.
 Nasya is a term applied generally when the medicine is administered through the nasal passage. It is considered as the most specific Panchakarama therapy used for the diseases of Siras (head) or Urdva jatru region, as nasal passage is regarded as the gateway to the head. In the present article the possible role of Nasya in the management of dysfunctional uterine bleeding is discussed. Nasya indirectly work on the entire body by improving the functioning of central nervous system and endocrine glands. The neurons which stimulate production of GnRH, originates from the olfactory area and GnRH is the regulator of gonadotropin hormones. The hormones of menstruation are under the control of these secreted by the pituitary. Nasya which is considered as having direct action on neuro-endocrinological system may regulate HPO axis and normalize the menstruation.

THE DYSFUNCTIONAL UTERINE BLEEDING (DUB) DUE TO ENDOMETRIAL HYPERPLASIA WITH BULKY UTERUS IN AYURVEDIC VIEW – CASE STUDY

ABSTRACT :-
 Endometrial is inner lining of uterus. Hyperplasia is excessive growth of cells. Endometrial Hyperplasia is excessive cell growth or thickness of inner lining of uterus. Endometrial hyperplasia is excessive or abnormal thickening of the lining of the uterus, which is most probable cause of Dysfunctional Uterine Bleeding (DUB). In most of the cases, it is benign in nature. The treatment of endometrial hyperplasia of uterus is mainly done by hormonal treatment (especially by progesterone) and by surgical treatment such as hysterectomy, which are having their own side effects. Ayurveda is a health care system sensitive to women’s special health needs. Women are far more sensitive to the rhythms and cycles of nature, Ayurveda is founded on the principle of keeping the body toned in time with nature, and naturally, women find Ayurveda very suitable. In Ayurveda, Endometrial hyperplasia of uterus can be correlated with Lohitakshara Yonivyapada. The present case revealed the Raktastambhaka, Shothhara evum Tridoshahara properties of some Ayurvedicmedicines viz. Pushyanuga Churna, Ashokarishta and Dashamoola Kashaya in a known case of DUB due to endometrial hyperplasia with Bulky Uterus. After 3 months of treatment sonography report showed no hyperplasia of uterus.
 AIMS AND OBJECTIVES 
 To evaluate the efficacy of Shamana Aushadhi in the management of Dysfunctional Uterine Bleeding (DUB) due to Endometrial Hyperplasia 
 MATERIALS AND METHODS
 It is a case study of the subject of 35 yrs age with Dysfunctional Uterine 
 Bleeding (DUB) due to Endometrial Hyperplasia who has been treated with Shamana Chikitsa.
 RESULTS AND DISCUSSION 
 The subject is on follow up and without any medicine on normal cyclic rhythm till date with overall feeling of wellbeing. There is improvement and no evidence recurrence of Dysfunctional Uterine Bleeding and Endometrial Hyperplasia.
 CONCLUSION 
 The selected treatment protocol i.e. Shamana Aushadha is very effective in the management of Endometrial Hyperplasia 
 KEYWORDS –​
 Ayurveda, Lohitakshara Yonivyapada, Endometrial Hyperplasia, Raktastambhaka Drugs

Comparative study of effectiveness of Ormeloxifene and Medroxy Progesterone Acetate in the management of Dysfunctional Uterine Bleeding

Comparative study of effectiveness of Ormeloxifene and Medroxy Progesterone Acetate in the management of Dysfunctional Uterine Bleeding

Comparative study of oral ormeloxifene and levonorgestrel IUCD in management of dysfunctional uterine bleeding

Comparative study of oral ormeloxifene and levonorgestrel IUCD in management of dysfunctional uterine bleeding

Yoga as a Therapeutic Intervention in the Management of Dysfunctional Uterine Bleeding: A Controlled Pilot Study.

Background:Dysfunctional uterine bleeding (DUB) is one of the most common gynecological disorders encountered in women during the reproductive age. Yoga therapy has shown promising benefits in several gynecological disorders.Methods:Thirty women between the ages of 20 and 40 years with primary DUB were randomly assigned to a yoga (n = 15) and a waitlist control group (n = 15). Participants in the yoga group received a 3-month yoga module and were assessed for hemoglobin values, endometrial thickness (ET), pictorial blood loss assessment chart (PBAC), State-Trait Anxiety Inventory, perceived stress scale, and Pittsburgh Sleep Quality Index (PSQI) before and after a 3-month follow-up period.Results:At the end of 3 months of intervention, the yoga group, unlike the control group, reported a significant reduction in the anxiety scores (P < 0.05) and perceived stress (P < 0.05). The PSQI scores indicated a reduction in sleep disturbances (P < 0.001) and the need for sleep medications (P < 0.01) and higher global scores (P < 0.001). However, there were no changes in PBAC and ET in both the groups.Conclusion:The results indicate that yoga therapy positively impacts the outcome of DUB by reducing the perceived stress and state anxiety and improving the quality of sleep. This warrants larger clinical trials to validate the findings of this pilot study.

Evaluation of antioxidant activity of ormeloxifene: in vitro study

Background: Ormeloxifene (Centchroman) is a Selective Estrogen Receptor Modulator (SERM) which acts as estrogen antagonist and having anti progestogenic activity also. It is being used in the management of dysfunctional uterine bleeding and as nonhormonal oral contraceptive. It is also being investigated for the indications such as osteoporosis, breast and endometrial carcinoma. In this study, we have evaluated the Antioxidant potential of drug by using DPPH and NO synthase Assay. It was found that ormeloxifene has significant antioxidant activity which could be cause for its use in various gynaecological and other conditions.Methods: In this study, we have demonstrated in vitro antioxidant activity of ormeloxifene. DPPH and NO synthase assay tests were done for different concentrations of ormeloxifene.Results: In our study, it showed that the free radical scavenging activity of ormeloxifene was less in lower concentration and increased in the higher concentration in DPPH assay. The free radical scavenging activity of drug ormeloxifene was 22% at 100µg/ml and 27% for the concentrations of 1000µg/ml in DPPH assay. No scavenging activity was 3% at 100µg/ml and 11% at 1000µg/ml.Conclusions: The invitro antioxidant analysis of ormeloxifene, was proved to be a potent antioxidant.

Efficacy of ormeloxifene in comparison to oral contraceptive pills in medical management of dysfunctional uterine bleeding

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Menstrual disorders are the most common gynecological condition resulting in hospital referrals. Dysfunctional Uterine Bleeding is an abnormal uterine bleeding, in the absence of any organic, systemic or iatrogenic cause. Among women in reproductive age, one in 20 consults her general practitioner each year with menorrhagia. This condition can be managed both medically and surgically. Pharmacological treatment options available for DUB are combined oral contraceptive pills, progestogens, danazol, gonadotrophin releasing hormone (GnRH) agonists, prostaglandin synthetase inhibitor, anti-fibrinolytics and ethamsylate. Role of ormeloxifene in dysfunctional uterine bleeding (DUB) is still in an exploring level.&lt;/span&gt;The purpose of the study was &lt;span lang="EN-IN"&gt;to evaluate the efficacy of ormeloxifene in the treatment of DUB and compare the effects of ormeloxifene with combined oral contraceptive pills for the control of DUB. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Sixty women presenting with DUB were randomly allocated to 2 equal groups, Group A were given ormeloxifene tablet @ 60 mg twice a week for 12 weeks, followed by 60 mg once a week for 12 weeks. Group B were given low dose combined oral contraceptive pills (OCP) containing 30 microgram ethinyloestradiol and 150 microgram levonorgestrel from day 1 to day 21st of the menstrual cycle for 6 cycles. The various parameters studied were reduction in menstrual blood loss which was measured by fall in pictorial blood loss assessment chart (PBAC) score, rise in haemoglobin (Hb) level and reduction in endometrial thickness, any drug side effects, compliance with the drug, dosage schedule and effect on quality of life after each month and at the end of trial period of 6 months. Patient’s level of satisfaction was assessed by improvement in Hb concentration, sense of wellbeing as well as overall general health, quality of life, sexual life and comfort with the continuation of the same drug.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Mean blood loss (PBAC score) following treatment showed significant reduction in both the groups, however this reduction was comparatively high in ormeloxifene treated group. The various parameters to assess the subjective and clinical improvement at the end 3 and 6 months post treatment showed significant improvement in both the treatment groups; however ormeloxifene group showed significantly better improvement in comparison to OCP group. Mean endometrial thickness also showed reduction in both the groups but more significant reduction was observed in ormeloxifene group as compared to OCP group following 6 months of treatment. Symptomatic relief and subjective feelings in relation to improvement of menstrual abnormalities, any undesirable side effects, about dosage compliance and any thought of discontinuing the drug by the patients indicated excellent control of menorrhagia in both the study group, which accounted for 86.66% in ormeloxifene group and 80% of individuals in OCP group. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; ORM is effective in control of DUB and can be used as an alternative to OCP for treatment of DUB with possibly minimal side effects and better dosage compliance.&lt;/p&gt;

Ormeloxifene-A new treatment modality in Dysfunctional Uterine Bleeding: efficacy and safety

Background/ Objective: To compare the efficacy and safety of ormeloxifene and norethisterone in the medical management of Dysfunctional Uterine Bleeding (DUB). Methods: 100 cases of DUB aged between 30 to 50years, who have completed child bearing, were randomly assigned ormeloxifene and Norethisterone groups. Ormeloxifene group received ormeloxifene 60 mg twice a week for 12 weeks and then once a week for next 12 weeks. Norethisterone group received norethisterone 5 mg twice daily for 21 days in every cycle for six cycles. Patients were followed up at end of 3rd and 6th month of therapy, and then at the end of 3rd month after treatment were stopped. The treatment with ormeloxifene and Norethisterone was evaluated by measuring the menstrual blood loss (MBL) by a pictorial blood loss assessment chart (PBAC), Hb g/dl and the endometrial thickness before and after 3 months of treatment. The side effects and patient acceptability of drug ormeloxifene were compared with norethisterone. Results: The mean PBAC score and Endometrial thickness (ET) in Norethisterone group and ormeloxifen group reduced significantly (P-value

English

OBJECTIVE: To evaluate the efficacy and safety of ormeloxifene in the medical management of dysfunctional uterine bleeding. DESIGN AND SETTING: A descriptive observational study was conducted on women with dysfunctional uterine bleeding, who attended to out - patient department of Obstetrics & Gynaecology in a National Institute Of Medical Science Medical College, shobha nagar, Jaipur (Rajsthan). MATERIAL AND METHOD: 54 patients with dysfunctional uterine bleeding were recruited for the study. Ormeloxifene 60 mg twice a week for 3 months from first day of periods and once a week for next 3 months was given. Mean blood loss (MBL) was assessed using pictorial blood loss assessment chart (PBAC). And subjectively by a visual analog scale (VAS).Ultrasonography (USG) for endometrial thickness and blood hemoglobin levels were done as baseline and at 1, 3 and 6 months of treatment. Side-effects of the drug were recorded. Changes in PBAC scoring, endometrial thickness (ET) and hemoglobin levels (Hb) were analyzed by student's paired 't' tests using SPSS 17.0 version. p value ≤ 0.05 was taken as significant. RESULT: The mean pretreatment MBL (PBAC score) was 343.13 (140-765), which reduced to 222.22 (80-398) at 1 months and 90.0 (0-340) at 3 months with treatment.By end of 6 months, the mean PBAC score was 68.84 (0-320). There was a significant reduction in MBL in patients on ormeloxifene (p-value ≤ 0.001).The rise in haemoglobin and decrease in ET,in women on ormeloxifene was also satistically significant(p value<o.oo1).Out of 54 patients,46 womens with menorrhagia were recruited in study. Three (6.52%) patients had no response, four (8.7%) patients were lost to follow-up. During the one year study period, 1(2.17) of the patients underwent hysterectomy.The most common side effect reorted was amenorrhea (28.26%). CONCLUSION: Ormeloxifene is very effective in improving all the parameters of blood loss in abnormal uterine bleeding including the no. of days of bleeding, no. of pads soiled and the passage of clots. Ormeloxifene has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule.

Effect of Ormeloxifene for Management of Dysfunctional Uterine Bleeding

Menorrhagia is an abnormal vaginal bleeding. Ormeloxifene is anti proliferative drugs which reduce production of various endometrial derived local factors and corrects menorrhagia with decrease menstrual blood loss (MBL) and clots. Therefore, we aimed to determine the effect of Ormeloxifene in women with dysfunctional uterine bleeding. We enrolled a total of 172 patients, aged 25 to 45 year, attended outpatient of gynecology department with complaints of heavy menstrual blood flow. Ormeloxifene was administered orally twice a week for first 12 weeks and then once in a week for next 12 weeks. MBL was measured using pictorial blood loss assessment chart (PBAC), blood hemoglobin. The median difference between pretreatment and post-treatment PBAC score was found to be significant. Similarly, It was also same with the difference in mean hemoglobin between pretreatment and post-treatment levels. The frequency distribution of clots during post treatment was significant as compared to pretreatment. Ormeloxifene is a cost effective effect therapy.

Efficacy and Safety of Ormeloxifene in the Management of Dysfunction Uterine Bleeding

Background: Dysfunctional uterine bleeding (DUB) is the most common cause of abnormal vaginal bleeding during a woman’s reproductive years. Regarding medical management of DUB, there is a general lack of evidence based approach, marked variation in the practice and continuing uncertainty regarding the most appropriate therapy. Ormeloxifine, a selective estrogen receptor modulator, is emerging as a safe and effective agent for dysfunctional uterine bleeding. Objective: To evaluate the efficacy and safety of ormeloxifene in medical management of dysfunctional uterine bleeding. Study Design: This was a prospective study conducted on DUB patients attending outpatient clinic in a tertiary care hospital. Materials and Methods: 50 patients, on whom diagnosis of dysfunctional uterine bleeding was made, were recruited for study. Patients were given ormeloxifine 60mg twice a week for 12 weeks and then once a week for 12 weeks. The primary outcome measures were menstrual blood loss (assessed by pictorial blood assessment chart score), hemoglobin concentration and endometrial thickness. The secondary outcome measures were acceptability and side effects of ormiloxifene. Results: There was a significant reduction in median PBAC score from 322 to 54 after six months of treatment. The mean hemoglobin concentration increased significantly from 8.1 to 9.4 gms/dl with a rise of 1.3gm/dl (p < 0.05). The mean pretreatment endometrial thickness was 11mm and it decreased significantly to 8.4mm after 6 months of treatment with ormeloxifene (p < 0.05). 76% of the women showed marked subjective improvement in symptoms. The most common side effect reported was amenorrhoea (16%). Conclusion: Ormeloxifene can be considered as an effective and safe therapeutic option for the medical management of dysfunctional uterine bleeding.

Comparing the effects of low-dose contraceptive pills to control dysfunctional uterine bleeding by oral and vaginal methods

Background and Objective : Contraceptive pills are generally taken orally and can cause side effects such as nausea, vomiting and hypertension. The vaginal use of these pills can reduce such complications. Our objective was to compare the efficacy and side effects of low dose contraceptive pills by oral and vaginal route in the management of dysfunctional uterine bleeding-(DUB) Methods: This comparative observational study was conducted at Beheshti and Alzahra (SA) teaching hospitals, affiliated to Isfahan University of Medical Sciences in 2010-2011. One hundred women who presented with DUB were randomly assigned into two groups of equal number, receiving the low dose oral contraceptive pills by oral or vaginal route for three month. The amount and duration of bleeding were compared at the beginning and at the end of the study and side effects by these two methods compared. The results of this study showed that both oral and vaginal routes effectively reduced the duration and amount of bleeding due to DUB after three courses of treatment. This effect was better in the vaginal method compared with oral administration (P = 0.03). Regarding the side effects, nausea and vomiting were significantly higher in the oral group than in the vaginal group (P = 0.03). Vulvovaginitis infection was more frequent in the vaginal group than in the oral group (P = 0.03). Low dose contraceptive pills are effective in reducing the amount, time, and duration of bleeding in patients with DUB. In addition, reduction of gastrointestinal side effects by vaginal route helps to use these pills by the patient with proper training of physicians, midwives and patients.

The Efficacy and Safety of Ormeloxifene in Dysfunctional Uterine Bleeding

The study was undertaken to assess the efficacy, safety and acceptability of ormeloxifene in the medical management of Dysfunctional Uterine Bleeding (DUB). Sixty women with DUB were given ormeloxifene 60mg twice a week for 12 weeks and once a week for next 12 weeks. Follow up was done at 3 and 6 months. The primary outcome measures were menstrual blood loss, hemoglobin concentration and endometrial thickness. The secondary outcome measures were the acceptability and side effects of ormeloxifene. There was a significant reduction in the menstrual blood loss as measured by median PBAC scores pre and post treatment. The median PBAC score was significantly reduced from 334 to 111 after 3 months and to 32 after 6 months (p < 0.0001) The mean pretreatment Hb concentration was significantly increased from 9.04gm% to 10.01 gm% at 3 months and to 10.86 gm% at 6 months (p<0.0001).The mean pretreatment endometrial thickness was reduced from 11.35mm to 9.4 mm after 3 months of therapy and to 8.13 mm after 6 months (p<0.0001). 88.3% women showed marked subjective improvement in symptoms. There were no major side effects. Ormeloxifene, with its convenient dose schedule, is an effective and safe alternative in the management of dysfunctional uterine bleeding.

The Role of Sevista in the Management of Dysfunctional Uterine Bleeding

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. The subjects were diagnosed cases of DUB. After ruling out the possible causes of the abnormal uterine bleeding, a diagnosis of DUB was made and the treatment with ormiloxifene was started. The number of cases were 35 cases. The treatment with ormeloxifene was evaluated by measuring the Hb g/dl and the endometrial thickness before and after 3 months of treatment with sevista. Ormeloxifene was given in the dosage of a 60 mg tablet twice a week for 3 months, followed by once a week for another 3 months. There was a statistically significant increase in the Hb g/dl (p < 0.001) and a statistically significant decrease in the endometrial thickness (p< 0.001) after the treatment with ormeloxifene. Ormeloxifene can be used asa effective drug in the treatment of Dysfunctional uterine bleeding.

A Study of Efficacy of Ormeloxifene in the Pharmacological Management of Dysfunctional Uterine Bleeding

This study was carried out to evaluate the efficacy of Ormeloxifene in the pharmacological management of dysfunctional uterine bleeding. A prospective study was conducted on women with dysfunctional uterine bleeding, who attended to out - patient department of Obstetrics & Gynaecology in a tertiary care general hospital. Women with DUB were diagnosed by presence of excessive, prolonged, or frequent intervals of bleeding for eight or more days, unrelated to anatomical lesions or systemic diseases. They were enrolled randomly and after baseline assessment each patient was treated with Ormeloxifene 60 mg orally twice a week for first 12 weeks, followed by once a week for another 12 weeks. The efficacy of the study drug was analyzed by comparing the baseline and post treatment PABC score, haemoglobin level, endometrial thickness, presence of clots in menstrual blood and dysmenorrhoea. The data obtained was analyzed using the paired t-test and Z-test. There was significant decrease in median PABC score from baseline to 25th week of treatment follow-up and the reduction was found to be statistically significant (p<0.001). There was also significant decrease in the mean endometrial thickness (p<0.001) after treatment with Ormeloxifene when compared to mean baseline value. The difference in mean haemoglobin level is 1.3 gm/dl between baseline and post treatment levels and was found to be statistically significant (p<0.001). There was significant improvement, 84% of patients had relief from dysmenorrhoea (p<0.001). No major adverse events were experienced by patients in this study. The results in this study indicate that Ormeloxifene, a non-steroidal, non-hormonal agent, provides effective and favourable pharmacological management option with least side effects, suitable for the treatment of dysfunctional uterine bleeding.