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

Abstract

Introduction: Dysfunctional uterine bleeding constitutes a considerable problem for many women causing discomfort and decreased quality of life. About 10-15% of women experience episodes of DUB at sometime during the reproductive years of their lives. Annually 5-19% of women seek medical care. It accounts for more than 25% of all hysterectomies. A wide range of treatment modalities are available.

Objectives: To study efficacy of oral ormeloxifene and levonorgestrel IUCD in terms of blood loss, endometrial thickness, hemoglobin concentration and to evaluate side effects in DUB.

Methods: 80 women presenting with dysfunctional uterine bleeding were allocated to 2 equal groups, group1: received 60mg oral ormeloxifene twice a week for 12 weeks and once a week for next 12weeks. Group2: received levonorgestrel IUCD. The primary outcomes were reduction in menstrual blood loss (measured by fall in PBAC score), rise in hemoglobin levels, decrease in endometrial thickness. The follow up was done at 3rdand 6thmonth.

Results: This study shows significant reduction in PBAC scores with use of ormeloxifene (P=<0.001) and also with Levonorgestrel IUCD (P=<0.001), hence reduction in blood loss. Significant increase in hemoglobin concentration with ormeloxifene (P=<0.001) and levonorgestrel IUCD (P=0.002) and decrease in endometrial thickness with ormeloxifene (P=<0.001) and levonorgestrel IUCD (P=<0.001). No statistical significant between the two groups.

Conclusion: Both ormeloxifene and levonorgestrel IUCD are equally efficacious and safe. Ormeloxifene is preferred for treatment of DUB as it is easy to administer and cheap compared to levonorgestrel IUCD which is costly and with few side effects like spotting, which makes patient apprehensive.