In a patient with heavy menstrual bleeding, is a levonorgestrel-releasing intrauterine system (LNG-IUS) better than oral contraceptive pills (or oral progesterone) for reducing bleeding?

2018 ◽  
Vol 21 (3) ◽  
pp. 6-7
Author(s):  
Allison Lale ◽  
Elise Halajian ◽  
Rick Guthmann
2019 ◽  
Author(s):  
Kimberly Huhmann ◽  
Andrea Zuckerman

Heavy menstrual bleeding is a common presenting problem in the adolescent population. The average age of menarche is between 12 and 13 years. The most common reason for heavy menstrual bleeding soon after menarche is from an immature hypothalamic ovarian access, which spontaneously resolves once cycles become ovulatory. However, the broad differential diagnosis for heavy menses in adolescents includes coagulopathy, thyroid disease, sexually transmitted infections, specifically chlamydia, and chronic medical conditions. Von Willebrand disease is the most common bleeding disorder that can present with heavy menstrual bleeding at menarche or shortly after. A thorough history and physical exam with occasional labs needs to be completed and can assist in narrowing the differential diagnosis. Treatment of heavy menstrual bleeding consists of hormonal and nonhormonal options: combination oral contraceptive pills, patches, or rings taken continuously or cyclically; progesterone-only pills; progesterone implants; progesterone intrauterine devices; cyclic tranexamic acid; cyclic aminocaproic acid; and GnRH agonists with add-back therapy. This review contains 3 tables, and 28 references. Key Words: adolescent menses, anovulation, bleeding disorder, heavy menstrual bleeding, immature hypothalamic ovarian axis, menarche, treatment of heavy menses, Von Willebrand disease


Author(s):  
Tarnima Saha ◽  
Meenakshi K. Bharadwaj ◽  
Shakti Vardhan

Background: Heavy menstrual bleeding (HMB) is one of the commonest presenting complaints in reproductive age group. Although combined oral contraceptives (COCs) are commonly used in such patients, combined hormones by intravaginal route has been found acceptable and effective. Aim of the study is to compare the efficacy and side effects of combined intravaginal hormonal ring (IHR) with COCs in control of HMB in these patients.Methods: Hundred women with HMB fulfilling inclusion criteria were randomized into two equal groups and treated with either IHR or COCs for three cycles. Each cycle consisted of three weeks of IHR/COC use followed by 1-week ring-free/non-hormonal pills period. Outcome measures were change in PBAC score (pictorial blood loss assessment chart), hemoglobin rise, side effects and overall patient satisfaction.Results: The percentage reduction in PBAC score, the duration of menses and increase in hemoglobin levels were statistically significant at the end of study in each group. The PBAC score reduction was 87.37% vs 61.52%, menses duration was 4.24±0.74 versus 5.16±1.67, and hemoglobin increase was 3.16 (95% CI:0.142-1.412) and 1.24 (95% CI:1.048-1.640) in the IHR versus COC group. However, the intergroup reduction of mean PBAC score was not statistically significant. Significantly more ring users were satisfied and elected to continue with treatment.Conclusions: Both the IHR and COCs are effective treatments for HMB in reproductive age group. IHR may be an attractive option for HMB due to better compliance and lesser systemic side-effects.


2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Sameerah Mustafa ◽  
Asal Tawfeeq ◽  
Hadeel Hasan

This study involved the collection of (90) samples of women serum which included (30) serum samples collected from women before menopause (reproductive women) in the age range of (22-43) years and were considered as (group A- control). While, (group B) included (30) serum samples collected from women using oral contraceptive pills between the ages of (22-43) years old. Whereas, another (30) serum samples were collected from women after menopause between the ages of (43-54) years and were considered as (group C). All of the collected serum samples were subjected to a number of serological and chemical tests for the measurement of (E2, HDL, LDL and Ca). Then, the obtained data were statistical analyzed and results showed a significant decrease (p˂ 0.05) in (E2 ,Ca and HDL) levels in menopausal women compared to that of the normal healthy controls. While, there were non-significant decrease (p> 0.05) in (E2, Ca and HDL) levels in women taking oral contraceptive when compared to the normal healthy controls. On the other hand, a significant increase (p˂ 0.05) was recorded in LDL level in menopausal women compared to that of the normal healthy controls whereas, no-significant increase (p˃ 0.05) in the LDL level in women taking oral contraceptives when compared to the control women.


2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.


1991 ◽  
Vol 29 (7) ◽  
pp. 28-28

We note an important correction to which the CMO, Health Trends and Prescribers Journal have already drawn attention. The first sentence of section 2.3.14 (p 37) should read “If any pill is omitted from the 21 days of active pills, additional contraception (barriers and spermicides) should be used for the 7 days after the pill(s) has been missed”.


2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Samuel Kusheta Katama ◽  
Desalegn Tsegaw Hibstu

Family planning is known not only as a fundamental intervention for improving the health of women but also as a human right. The aim of this study was to assess the current knowledge, attitude and practice of contraceptive use among female students in Dilla secondary and preparatory school, Dilla, South Ethiopia, 2014. A cross sectional study was conducted among 288 female students in Dilla secondary and preparatory school, south Ethiopia, June 19- 29/2014. A simple random sampling technique was used to select the study subjects. The data was collected using a self-administered structured questionnaire. The data was analyzed by SPSS 20. Chi-square test was used to identify associated factors. A total of 263 female students were involved in this study, of which 249 (94.7%) had good knowledge about contraception. The three most frequently identified methods were injectable form (83.9%), oral contraceptive pills (72.7%) and condom (48.6%). A total of 15.7% respondents ever used contraceptive. Among the users, 56.4% used oral contraceptive pills, and 23.1 and 10.2% used injectable form and condom, respectively. In spite of the fact that most respondents had good knowledge of contraception, their attitude and practice was low. Emphasis needs to be given on disseminating health information concerning the attitude and practice of contraceptive method.


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