scholarly journals Ormeloxifene in the management of dysfunctional uterine bleeding

2018 ◽  
Vol 7 (5) ◽  
pp. 1885
Author(s):  
L. Thulasi Devi ◽  
Ravi Nimonkar
Keyword(s):  
Side Effects ◽  
Medical Management ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Uterine Bleeding ◽  
Brand Names ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Receptor Modulator ◽  
One Year

Background: Dysfunctional Uterine Bleeding (DUB), is the commonest cause of Abnormal Uterine Bleeding (AUB). It causes morbidity, anaemia, and unnecessary hysterectomies in women of fertile age group. This study attempts to study efficacy of medical management especially Selective Estrogen Receptor Modulator (SERM) namely Ormeloxefine (ORM) (Sevista®) in Perimenopausal women. Ormeloxifene was marketed in India for contraception under brand names Centron, Saheli, Choice-7, Novex and Novex-DS. It’s a benzopyran derivative also known as Centchroman which causes asynchronousity between ovulation and menstrual cycles possibly because of both estrogenic and anti-estrogenic actions. It has been known to cause delay in ovulation in clinical trials; however, majority have been unaffected. It causes delay in proliferation of endometrium thereby causing asynchronous cycles. It also improves motility of ciliary lining of Fallopian tubes thereby reducing the chances of implantation of fertilized egg.  Methods: This study is aimed at evaluation of subjective and objective stastical benefits and side effects in treatment of DUB in perimenopausal age group with ORM and commonly used 19 nortestosterone compound (progesterone); Norethisterone (NET).Results: Primary outcome were analyzed at the end of every 3 months and at the end of one year finally. Secondary outcomes of the study in each arm were also assessed. There was stastically significant increase in Hb and stastically significant decrease in ET. Data analysis was done for variables in each arm by t-test to estimate the mean, median, range P and t value for a conclusion. Differences were taken as significant when P<0.05.Conclusions: ORM is a safe, cost effective, non-steroidal, non-hormonal drug with convenient dosage and better compliance for medical management of perimenopausal DUB with minimum focal pathology. Side effects observed need more evaluation with larger sample size to be statistically significant.

scholarly journals A clinicopathological study of dysfunctional uterine bleeding

2014 ◽  
Vol 4 (8) ◽  
pp. 635-638
Author(s):  
N Katuwal ◽  
G Gurung ◽  
A Rana ◽  
A Jha
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
University Teaching ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Obstetrics And Gynaecology ◽  
Proliferative Endometrium ◽  
One Year ◽  
Complete History

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding when there is absence of organic disease of the genital tract. The objective of this study was to find out the clinical and pathological aspect of women presenting with dysfunctional uterine bleeding.Materials and Methods: A descriptive study was conducted over a period of one year from April 14th 2010 to April 13th 2011 in the Department of Obstetrics and Gynaecology and Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A complete history, clinical examination, pelvic scan, hormonal status if required and endometrial biopsy were done to diagnose dysfunctional uterine bleeding.Results: A total of 120 cases were included. The age of the patients diagnosed dysfunctional uterine bleeding were ranging from 24 -63 years. Dysfunctional uterine bleeding was most common in the age group 40-44 yrs (30%) followed by 45-49 yrs (27.5%). Menorrhagia (41.7%) was the most common presenting sign. Majority histopathology of endometrium revealed anovulatory pattern (61.7%) followed by ovulatory (38.3%). Of the cases with an anovulatory pattern 48.6% was proliferative endometrium, 33.8% disordered proliferative endometrium, 6.8%atrophic, 5.4% weakly proliferative and 2.7% each of simple hyperplasia without atypia and complex hyperplasia with atypia. All cases with ovulatory pattern showed secretory endometrium.Conclusion: Dysfunctional uterine bleeding was the most common in the perimenopausal age group and chiefly in the form of an anovulatory endometrium. . Histopathological evaluation of endometrium helps exclude the local causes and establishes the diagnosis of dysfunctional uterine bleeding, its types, and clinical correlation to histopathological findings and finally helps to determine the mode of management.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11500 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 635-638

scholarly journals COMPARISON OF EFFICACY AND SAFETY OF ORMELOXIFENE AND CYCLICAL PROGESTERONE (NORETHISTERONE) IN OVULATORY ABNORMAL UTERINE BLEEDING

2020 ◽  
pp. 178-180
Author(s):  
DIVYA VARDAINI ◽  
RAKESH MISHRA ◽  
RASHMI RANJAN ◽  
SWAPNALI R BORADE
Keyword(s):  
Blood Loss ◽  
Medical Management ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Age Group ◽  
Efficacy And Safety ◽  
Reproductive Age Group

Objective-To determine the efficacy and safety  of ormeloxifene versus progesterone in controlling Ovulatory Abnormal Uterine Bleeding(AUB-O) Methods-A Prospective Randomized comparative study of total 100 females of reproductive age group 25 to 45 years with AUB-O.Patients were randomly divided in two groups of 50 each. Results-The study showed ormeloxifene was found to be more effective and safe than Norethisterone in AUB-O. Ormeloxifine as compared to norethisterone is more effective in improving Hb and reducing endometrial thickness. Hence, ORM is more superior than Norethisterone Conclusion-In this study ormeloxifene was found to be more effective in reducing blood loss,that leads to improvement in mean haemoglobin and also it had more ability to reduce endometrial thickness.As both ormeloxifene and norethisterone are very effectivebut ormeloxifene is safe , cost effective ,nonsteroidal, non hormonal drug with convenient dosage and better compliance for medical management of AUB-O.Hence, ormeloxifene canbe considered as first drugs in the management of AUB-O.

A PROSPECTIVE ANALYTICAL STUDY OF PATIENTS WITH DYSFUNTIONAL UTERINE BLEEDING.

2021 ◽  
pp. 1-2
Author(s):  
Mangal Supe ◽  
Anup Arun Gundecha
Keyword(s):  
Social Life ◽  
Analytical Study ◽  
Systemic Disease ◽  
Abnormal Uterine Bleeding ◽  
Study Data ◽  
Uterine Bleeding ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Endometrial Pattern ◽  
Considerable Morbidity

Background: Dysfunctional uterine bleeding is dened as abnormal uterine bleeding not caused by any pelvic pathology, medications, pregnancy related complications or any systemic disease. It is the most common cause of abnormal uterine bleeding. It affects pubertal adolescents and perimenopausal women and is associated with considerable morbidity and affects patient’s family, personal and social life. Patient presents as menorrhagia, polymenorrhea, metrorrhagia or intermenstrual bleeding. It has great variations in endometrial patterns each deciding treatment modality. Objective: To determine frequency of various types of abnormal uterine bleeding and analyze the histopathology of endometrial curettage samples. Method: A prospective analytical study was conducted from Jan 2018 to Dec 2019 on sample of 650 patients between 20-70 years of age with symptoms of dysfunctional uterine bleeding presenting to medical college and hospital, Pimpri. Their endometrial samples were obtained by dilatation and curettage. To have a broader analysis the endometrial histopathology on hysterectomy specimens where the clinical diagnosis was DUB were also included in the study. Data obtained was tabulated and analyzed. Conclusion: The age group 31-40 and 41-50 years was the most common age group presenting with DUB. The predominant pattern of presentation was menorrhagia. The most common endometrial pattern on histopathology was proliferative type.

scholarly journals A retrospective study of endometrial histopathology in abnormal uterine bleeding patients

2018 ◽  
Vol 7 (10) ◽  
pp. 4116
Author(s):  
Neha Varun ◽  
Nidhi Gupta ◽  
Sana Khan
Keyword(s):  
Retrospective Study ◽  
Endometrial Hyperplasia ◽  
Diagnostic Procedure ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Uterine Bleeding ◽  
Age Group ◽  
Medical College ◽  
Different Types ◽  
Proliferative Endometrium

Background: Abnormal uterine bleeding (AUB) is one of the most commonly encountered gynecological problem and almost 33 % of women in gynecological outpatient department presented with abnormal uterine bleeding. Dilatation and curettage (D and C) have been the main diagnostic procedure in the evaluation of abnormal uterine bleeding patients for decades. The objective of the present study was to analyze the different types of endometrial histopathology of patients presented with the abnormal uterine bleeding and its correlation with the different types of abnormal uterine bleedingMethods: This is a retrospective study, conducted in a medical college in the Department of Obstetrics and Gynecology over a period of one year from June ’17 to June ’18. All cases of AUB more than 35 years of the age group who underwent D and C procedure were included in this study. Total 100 patients were analyzed.Results: Total 100 patients were analyzed. Age group ranges from 35-58 years and most common age group presenting with AUB was 35-39 years. The most common presenting complaint was menorrhagia 54% (54/100). Histopathology of endometrium showed non-organic causes in 80% (80/100) of AUB patients and the remaining 20% (20/100) had organic causes. Most common endometrial histopathology among non-organic causes was proliferative endometrium 43.75% (35/80) and the most common organic cause was endometrial polyp 40% (8/20). Endometrial hyperplasia was found in 30% (6/20) and endometrial carcinoma was found in 20% (4/20) of cases among organic causes.Conclusions: D and C is the useful and the cost-effective diagnostic procedure in the evaluation of AUB. Histopathological evaluation of endometrial samples is especially indicated in AUB patients to rule out carcinoma and preneoplastic conditions as histopathology is 100% diagnostic in cases of endometrial hyperplasia and carcinoma.

scholarly journals Comparative Study of Desogestrel- Containing Oral Contraceptive and Levonorgestrel- Containing Oral Contraceptive in Dysfunctional Uterine Bleeding

2020 ◽  
Vol 11 (4) ◽  
pp. 5678-5684
Author(s):  
Swathi Suresh ◽  
Mariya Els Johny ◽  
Kiruba Shankari ◽  
Ahamed Irshath U ◽  
Yokesh M ◽  
...  
Keyword(s):  
Weight Gain ◽  
Oral Contraceptive ◽  
Side Effects ◽  
Menstrual Cycle ◽  
Blood Loss ◽  
Ethinyl Estradiol ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Dysfunctional Uterine Bleeding ◽  
Group D

Dysfunctional uterine bleeding is a type of abnormal uterine bleeding where vaginal bleeding occurs outside of the menstrual cycle in the absence of any known pelvic pathology. Dysfunctional uterine bleeding can be treated safely with hormone therapy. Combined oral contraceptives help in increased menstrual cycle regularity and decreased blood loss. In this study, a reliable drug for the dysfunctional uterine bleeding with maximum effectiveness and minimal side effects were assessed. This study was conducted on 120 cases of dysfunctional uterine bleeding. Patients who were diagnosed with dysfunctional uterine bleeding were randomly assigned into two groups. Group D and group L included patients who were given Ethinyl estradiol 0.02mg + desogestrel 0.15mg and Ethinyl estradiol 0.03mg + levonorgestrel 0.15mg respectively for the four consecutive 28- day cycles. Menstrual blood loss was assessed using the pictorial blood assessment chart (PBAC) score on 2nd and 4th months of recruitment. Side effects such as weight gain, acne and headache were assessed in both groups. This study shows 56.68% reduction in mean PBAC score in 2 months in desogestrel group whereas only 44.96% reduction in levonorgestrel group and 79.87% reduction in mean PBAC score in desogestrel group in 4 months whereas only 74.46% reduction in levonorgestrel group. Side effects like weight gain, acne and headache were more prominent in the levonorgestrel group than desogestrel group. Desogestrel containing combined oral contraceptive can be a useful and safe treatment for dysfunctional uterine bleeding.

scholarly journals Abnormal Uterine Bleeding – A Clinico-pathological Study

2021 ◽  
Vol 8 (1) ◽  
pp. A9-13
Author(s):  
Sarita . ◽  
Nisha J Marla ◽  
Nagarathna . ◽  
Jayaprakash C S
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Reproductive Period ◽  
Uterine Bleeding ◽  
Target Organ ◽  
Direct Access ◽  
Age Group ◽  
Morphological Findings ◽  
Dilatation And Curettage ◽  
Proliferative Endometrium

Background: Abnormal Uterine Bleeding (AUB) can occur at any age in a woman`s reproductive period and needs to be assessed very carefully and immediately. When it occurs in the older age group, a more meticulous screening for malignancy is imperative so that treatment can be more radical. Dilatation and curettage is a simple, cost effective, safe and a reliable investigation and it gives us a direct access to the target organ. Methods: Study was conducted prospectively on 162 patients presenting with AUB in reproductive, perimenopausal and postmenopausal age group. All the endometrial samples procured from the endometrial curettage were fixed in 10% buffered formalin for 12-24 hours, processed in the automated tissue processor, cut and stained with Hematoxylin & Eosin (H & E) stain and were finally studied in detail for the morphological findings under light microscopy. Result: In our study Secretory endometrium was most common type, which was followed by Proliferative endometrium. Disordered proliferative endometrium and Endometrial hyperplasia were the commonest histopathological patterns seen in AUB of organic type. Endometrial carcinoma was seen more commonly in postmenopausal age group. Further, in our study Mc Cluggage criteria was applied to all the samples to categorize endometrial samples which were unassessable and inadequate. Conclusion: Evaluation of Endometrial samples is important in all patients with Abnormal Uterine Bleeding (AUB) to find out the Organic Pathology. Histopathological typing of endometrium is crucial for appropriate therapy. Its interpretation is quite challenging and also may show considerable interobserver variability. In AUB, the endometrial samples should be taken during the bleeding episode itself. Dilatation and curettage is a simple, cost effective, safe and reliable investigation and gives us a direct access to the target organ.

scholarly journals Histopathological study of endometrium in dysfunctional uterine bleeding

2018 ◽  
Vol 7 (9) ◽  
pp. 3497
Author(s):  
Malarvizhi Loganathan ◽  
Meera Krishnakumar
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Histological Change ◽  
Uterine Bleeding ◽  
Histopathological Study ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Medical College ◽  
Histopathological Studies ◽  
The Right ◽  
Secretory Endometrium

Background: This study was undertaken to study the endometrial histology in patients presenting with abnormal uterine bleeding in the absence of palpable pelvic pathology, which helps in choosing the right modality of treatment in a particular age group with a specific histological change. The study of endometrium in dysfunctional uterine bleeding was undertaken to correlate clinical presentations with histopathological studies and to correlate the distribution of histopathological findings in various age groups.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology at Govt. Dharmapuri Medical College and Hospital during the period 01.07.2017 to 31.05.2018. Patients presenting to Govt. Dharmapuri Medical College and Hospital with abnormal uterine bleeding form the material of this study. Cases have been selected by using purposive sampling technique.Results: An ovulatory cycles were more common than ovulatory cycles in all age group. However, in patients with menorrhagia and polymenorrhagia majority had secretory endometrium (ovulatory cycles).Conclusions: Majority of the patients were found in the reproduction age group with the maximum percentage in multiparous women. Menorrhagia was the commonest mode of presentation in all age group. Most of the patients with proliferative and secretory endometrium had normal sized uterus and normal looking endometrium.

scholarly journals The role of Sevista (ormeloxifene) in the management of dysfunctional uterine bleeding

2016 ◽  
Vol 6 (1) ◽  
pp. 219 ◽  
Author(s):  
Nikita Gandotra ◽  
Preeti Sharma ◽  
Abhinav Sharma ◽  
Syed Masuma Rizvi
Keyword(s):  
Side Effects ◽  
Outcome Measures ◽  
Medical Management ◽  
Endometrial Thickness ◽  
Hemoglobin Concentration ◽  
Uterine Bleeding ◽  
Secondary Outcome ◽  
Dysfunctional Uterine Bleeding ◽  
The Mean

Background: Dysfunctional uterine bleeding (DUB) is a common gynaecological disorder that usually ends up in hysterectomy and causes psychological and physiological stress. Medical management with hormones and NSAIDS has inherited side effects. Ormeloxifene, a selective estrogen receptor modulator, is emerging as a safe and effective agent for dysfunctional uterine bleeding. The objective of the study was to evaluate the role of ormeloxifene in medical management of dysfunctional uterine bleeding.Methods: 30 patients, on whom diagnosis of dysfunctional uterine bleeding was made, were included in the study. Patients were given ormeloxifene 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 ormeloxifene.Results: There was a significant reduction in mean PBAC score from 316 to 52 after six months of treatment. The mean hemoglobin concentration increased significantly from 8.4 to 9.8 gms/dl with a rise of 1.4gm/dl (p <0.05). The mean pretreatment endometrial thickness was 10.8mm and it decreased significantly to 8.1mm after 6 months of treatment with ormeloxifene (p < 0.05). 76.7% of the women showed marked subjective improvement in symptoms. The most common side effect reported was amenorrhea (13.3%).Conclusions: Ormeloxifene can be considered as an effective and safe therapeutic option for the medical management of dysfunctional uterine bleeding.

scholarly journals Study of histopathological patterns of endometrium in abnormal uterine bleeding

2021 ◽  
Vol 10 (4) ◽  
pp. 1401
Author(s):  
Anitha S. ◽  
Pooja G. ◽  
Sowmya D.
Keyword(s):  
Histopathological Examination ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Research Centre ◽  
Age Group ◽  
Endometrial Sampling ◽  
Endometrial Pattern ◽  
Post Menopausal ◽  
One Year

Background: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology out- patient department. Endometrial sampling could be effectively used as the first diagnostic step in AUB. This study was done to evaluate histopathology of endometrium for identifying the endometrial causes of AUB. And also, to observe the incidence of various endometrial pathology in different age groups presenting with abnormal uterine bleeding.Methods: A one-year prospective study conducted in the department of obstetrics and gynaecologist in A. J. institute of medical sciences and research centre which included 200 cases of clinically diagnosed AUB patients. Histopathological examination of endometrial biopsies specimens was done, followed by clinical correlation.Results: The most common age group presenting with AUB was 41-50 years (43.84%). The commonest pattern in these patients was normal cycling endometrium (42.32%). The commonest pathology irrespective of the age group was disordered proliferative pattern (26.15%). Other causes identified atrophic endometrium (11.5%), benign endometrial polyp (5.38%), endometrial hyperplasia (5.41%), carcinomas (0.79%) and chronic endometritis (1.54%).Conclusions: The knowledge of endometrial pattern in a case of AUB helps to decide a plan of management. Endometrial sampling plays a very important role in management of AUB, especially in the age group of more than 40 years; i.e., the peri and post-menopausal age groups, where incidence of malignant or pre malignant conditions was noted to be the highest.

scholarly journals Study on Thyroid Dysfunction in Patients of Dysfunctional Uterine Bleeding

2021 ◽  
pp. 44-49
Author(s):  
Koduru Mounika
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Abnormal Uterine Bleeding ◽  
Common Type ◽  
Uterine Bleeding ◽  
Thyroid Disorder ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Medical College ◽  
Hyperthyroid Patients

Aim: The purpose of the study was to detect thyroid dysfunction in women who had abnormal uterine bleeding Study Design: Menorrhagia was the most common type of bleeding (36%). Thyroid dysfunction was discovered in 32% of the patients (Subclinical hypothyroidism in 17%, Hyper thyroid is 11% and hyperthyroidism in 4 % of cases). The researchers looked at 100 cases of Dysfunctional Uterine Bleeding that were clinically identified at Sree Balaji Medical College and Hospital between March 2014 and August 2016. The patients in this study ranged in age from under 20 to 45 years old. The number of instances with DUB who were between the ages of 31 and 40 is 38 %. Methodology: The parity of the patients ranged from unmarried to 0-5, with the parity 2 group accounting for 37% of all DUB patients and the following assessments were made. Results: Thyroid dysfunction was most common in cases of polymenorrhagia (42.8%), menorrhagia (33.3%), polymenorrhea (28.5%), and oligomenorrhea. (26%). Thyroid dysfunction was most common in the age group 31-40 years, accounting for 77.5% of the population. In 17 % of cases, the primary thyroid malfunction was subclinical hypothyroidism. 3% of hyperthyroid patients were also oligomenorrhocic. The most prevalent thyroid disorder in metrorrhagic patients was subclinical hypothyroidism.

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