Abstract

Objective: To compare efficacy and acceptability of the levonorgestrel releasing intrauterine system and norehisterone for treatment of idiopathic menorrhagia.

Study Design: Randomized control trial.

Place and Duration of Study: Department of Obstetrics and Gynaecology Department, Pakistan Ordinance Factory Hospital, Wah Cantt from 1st July 2009 30th June 2010.

Methodology: Seventy six patients with regular and heavy menstrual bleeding with decrease hemoglobin levels, age ranging between 35-45 years were selected. These patients were having anemia and the other general physical examinations were normal. The pelvic examination was also normal. The cervical smear cytology was unremarkable. They were divided into two groups; Group A, levonorgestrel releasing intrauterine system (Mirena) was inserted into the uterus and group B, Norethisterone tablet was prescribed at a dose of 5 mg three times a day. Haemoglobin, number of days of menstruation per month and number of pads soaked per day were noted.

Results: The mean age in group A was 39.89±3.24 years and mean age in group B was 40.58±3.42 years and number of parity in group A was 4.53±1.08 and in group B 4.26±1.31. The mean haemoglobin in group A was 10.89±0.30 and in group B was 10.82±0.32. Statistically there was no significant (P>0.05) difference between two groups. The mean number of days in group A was 2.00±0.81 and in group B was 3.63±0.75. Statistically there was significant (P<0.05) difference between two groups. The mean number of pads used in group A was 1.63±0.67 and in group B was 2.68±0.62. Statistically there was significant (P<0.05) difference between two groups. When compared the patient’s acceptability, 30 (78.9%) women have acceptability in group A while in group B, 28 (73.6%). Statistically there is no significant (P>0.05) difference between the two groups.

Conclusion: The norethisterone and levonoregestrel releasing intrauterine system are effective treatments for menorrhagia. The subsequent is very effective treatment of idiopathic menorrhagia and is associated with higher rates of satisfaction as compared to norethisterone therapy.

Key Words: Trial, Levonorgestrel releasing intrauterine system, Norethisterone, Idiopathic menorrhagia