scholarly journals A randomized controlled trial to study the efficacy of intravaginal hormonal ring for control of heavy menstrual bleeding as compared to combined oral contraceptive pills

2020 ◽  
Vol 9 (3) ◽  
pp. 1205
Author(s):  
Tarnima Saha ◽  
Meenakshi K. Bharadwaj ◽  
Shakti Vardhan
Keyword(s):  
Side Effects ◽  
Controlled Trial ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Age Group ◽  
Loss Assessment ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Reproductive Age Group

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.

Heavy Menstrual Bleeding in the Adolescent

2019 ◽  
Author(s):  
Kimberly Huhmann ◽  
Andrea Zuckerman
Keyword(s):  
Differential Diagnosis ◽  
Aminocaproic Acid ◽  
Bleeding Disorder ◽  
Von Willebrand Disease ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Oral Contraceptive Pills ◽  
Sexually Transmitted ◽  
Contraceptive Pills ◽  
Von Willebrand

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

Clinical trial with continuous low dosage (0·5 mg) chlormadinone acetate

1972 ◽  
Vol 4 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Shanti M. Shahani ◽  
Manjari K. Munsif
Keyword(s):  
Side Effects ◽  
Drop Out ◽  
Reproductive Age ◽  
Age Group ◽  
Breakthrough Bleeding ◽  
Chlormadinone Acetate ◽  
Drop Out Rate ◽  
Normal Duration ◽  
Low Dosage ◽  
Reproductive Age Group

Chlormadinone acetate (0·5 mg) was given continuously to 200 patients for 1512 cycles in an investigation lasting a little over 2 years. Only a small number of the women stayed in the trial for the whole period. The women were in the reproductive age group and of proved fertility. Lack of cycle control was the chief drawback. However, the majority of the cycles were of normal duration, intensity and flow. Breakthrough bleeding occurred in 3·8% of the total cycles. Of the patients 49% had side effects in 18·6% of the cycles. They were common in the first 3 months but were mild. No pregnancy occurred due to method failure. Six pregnancies occurred due to tablet omission on 2 or more days. A heavy drop-out rate of 78·5% was found. The majority of the patients who dropped out did so for reasons not related to the drug; only 14% of the patients dropped out due to side effects. Vaginal cytohormonal study, premenstrual endometrial biopsies and postcoital tests were carried out during the trial to study the mode of action of the drug.

scholarly journals Knowledge, attitude and practices of contraception among the married women of reproductive age group in urban slums of Lucknow

2021 ◽  
Vol 9 (6) ◽  
pp. 1716
Author(s):  
Neeti Verma ◽  
Prashant K. Bajpai
Keyword(s):  
Family Planning ◽  
Married Women ◽  
Reproductive Age ◽  
Age Group ◽  
Contraceptive Methods ◽  
Cross Sectional ◽  
Training Centre ◽  
Oral Contraceptive Pills ◽  
Wide Range ◽  
Reproductive Age Group

Background: Despite the availability of a wide range of contraceptive and mass media campaigns and information, education, and communication programs, population control remains a distant dream to achieve. The low use of spacing methods is reflected by early childbearing and short birth intervals. The present study was undertaken to assess the knowledge, attitude, and practice of different contraceptive methods among married women in the reproductive age group.Methods: A cross-sectional study was conducted among 230 married women in the reproductive age group (18-49 years) attending the outpatient department (OPD) of urban health training centre and came mainly from the neighboring slum locality.Results: We have included a total of 230 participants in the study analysis. Almost all (98.6%) of the study participants had knowledge about at least one method of contraception. If we see the use of contraceptive methods, 163 (70.8%) women ever used any of the contraceptive methods. Less than half (40.9%) had knowledge that contraceptive methods reduce the economic burden on the family. A negative attitude towards the practice of contraception was found among 11.7 percent of women in the study. When asking about present (last 1 year) practice of contraception, 29.1% not practiced any method of contraception, 25.6% used oral contraceptive pills (OCPs), and 27.8% used condoms.Conclusions: The study reveals good knowledge and favorable attitude of rural couples towards contraception. Contraceptive knowledge and practice were influenced by exposure to family planning messages. Women's education and counselling of couples can play an important role in adopting family planning methods.

scholarly journals Role of LNG-IUS in adenomyosis in reproductive age group women: a prospective interventional study

2019 ◽  
Vol 8 (4) ◽  
pp. 1254
Author(s):  
Eshna Gupta ◽  
Shashi Prateek ◽  
Poonam Mani ◽  
Lalita Yadav ◽  
Mamta Tyagi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Assessment Tool ◽  
Subjective Assessment ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Common Side Effect ◽  
Loss Assessment

Background: The objective of the present study was to observe the efficacy of LNG-IUS in the treatment of heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis.Methods: LNG-IUS was inserted in forty women between 20-50 years of age presenting with heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis diagnosed on transvaginal ultrasonography and followed up after 1 month, 3 months and 6 months of insertion. Subjective assessment of menstrual blood loss was done by pictorial blood loss assessment chart and dysmenorrhoea was assessed on the basis of universal pain assessment tool and side effects were noted at each visit.Results: Mean patients’ age was between 31-40 years (72.5%) and the follow up duration was 6 months. Significant improvements in dysmenorrhea, HMB and haemoglobin levels were observed. There was no significant change in the uterine volume. The most common side effect was prolonged vaginal spotting (n=26, 65%) and pain abdomen (n=13, 32.5%). LNG-IUS expulsion was observed in 1 patient (n=1, 2.5%). 3 patients underwent hysterectomy (n=3, 7.5%). The overall success rate of LNG-IUS was 82.5%.Conclusions: The LNG-IUS appears to be an effective method in alleviating dysmenorrhoea and heavy menstrual bleeding associated with adenomyosis during 6 months of study. It may be a valuable long-term alternative for the treatment of adenomyosis in young and perimenopausal women and it is a good strategy to reduce the number of hysterectomies in women with adenomyosis.

scholarly journals A study on assessment of unmet need and contraceptives practices adopted among currently married females residing at urban slums of Ahmedabad

2021 ◽  
Vol 8 (4) ◽  
pp. 1863
Author(s):  
Disha R. Geriya ◽  
Venu R. Shah ◽  
Viral R. Dave ◽  
Kantibhai N. Sonaliya
Keyword(s):  
Family Planning ◽  
Age Groups ◽  
Unmet Need ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Age Group ◽  
Cross Sectional ◽  
Oral Contraceptive Pills ◽  
Reproductive Age Group ◽  
Group 1

Background: India is a country where population is rapidly growing, to slow down this growth rate family planning is necessary. Family planning services have the potential to improve the quality of the lives and economic welfare of people. Aim of the study was to assess prevalence of unmet need, knowledge, attitude regarding family planning methods and contraceptive practices, among study participants.Methods: A cross- sectional study was carried out among females of early reproductive age group 18-25 years, Group-1 and late reproductive age group 35-49 years, Group-2Results: Out of 200 women, majority respondents belonged to age group of 22-25 years (44.5%). Females of both age-groups had almost similar (54% and 53%) knowledge “partially correct” type for objectives of family planning and had similar positive attitude (78% and 85%) towards family planning practices. Total 45% of group 1 and 55% of other group females were currently using contraception. Most common method used by group 1 women was Intra Uterine Devices (35.5%), followed by Oral Contraceptive pills (31.2%) and in group 2 women was permanent sterilization (74.5%) followed by barrier and Intra Uterine Devices (9.1% each). Unmet need of family planning was 29% and 18% among early and late reproductive age groups, respectively.Conclusions: Unmet need of family planning was higher among early age group females. In both age groups, utilization of contraceptives were less because of lack of awareness and fear of side effect.

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