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Potentially effective therapy of heavy menstrual bleeding with an oestradiol-nomegestrol acetate oral contraceptive: a pilot study

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ABSTRACT

Background: Heavy menstrual bleeding (HMB) exceeding 80 mL per cycle leads to considerable adverse impact on a woman’s iron metabolism, incidence of iron deficiency and anaemia, as well as her functioning in society.

Background: The objective of the study is to determine the potential efficacy of a Monophasic oestradiol-17β-nomegestrol acetate (E2/Nomac) combined oral contraceptive pill on measured menstrual blood loss as a pilot study in 12 women with objectively demonstrated HMB (>80 mL per cycle). The pilot study aimed to recruit 20 women.

Method: Consented women completed the HMB questionnaire. The blood was taken for haemoglobin, transferrin, iron saturation, TIBC, serum iron and ferritin. Women were given verbal and written detailed instructions for MBL collection for three control cycles and four treatment cycles.

Results: Forty-three women were enrolled, but 31 were ineligible and withdrawn (mainly for failure to meet eligibility criteria). Twelve women entered the treatment phase and commenced the E2/nomegestrol acetate (NOMAC) 24/4 combined pill treatment on the first day of their fourth cycle. All women with complete MBL measurements had >50% reduction in MBL on treatment (exact 95% confidence interval for proportion with MBL reduction >50%: 69 to 100%). The mean percent reduction in MBL between pretreatment and during treatment was 76.9%, and the median was 79% with a range of 53.7 to 100%.

Conclusions: This pilot study indicates that the E2/NOMAC COC will provide a useful potential option for treating HMB in women with FIGO classification AUB-E (primary endometrial causes) but requires a larger placebo-controlled study for confirmation.

No MeSH data available.


Mean paired pretreatment MBL for three pre-treatment cycles and three cycles on treatment with E2/NOMAC for 12 individual women
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Fig2: Mean paired pretreatment MBL for three pre-treatment cycles and three cycles on treatment with E2/NOMAC for 12 individual women

Mentions: The mean percent reduction in MBL between pretreatment and during treatment cycles was 76.9% and the median was 79% (with a range of 53.7 to 100%) (Table 2). The two subjects with only two post-treatment collections also had 81.2 and 79.9% reduction in MBL respectively. The median absolute reduction in monthly blood loss was 98 mL per period per subject with a range of 39–185 mL. Individual reductions in MBL between pre- and during treatment are shown in Fig. 2. In 33 of 34 treatment cycles, blood loss had reduced to within the normal range (<80 mL).Table 2


Potentially effective therapy of heavy menstrual bleeding with an oestradiol-nomegestrol acetate oral contraceptive: a pilot study
Mean paired pretreatment MBL for three pre-treatment cycles and three cycles on treatment with E2/NOMAC for 12 individual women
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5385594&req=5

Fig2: Mean paired pretreatment MBL for three pre-treatment cycles and three cycles on treatment with E2/NOMAC for 12 individual women
Mentions: The mean percent reduction in MBL between pretreatment and during treatment cycles was 76.9% and the median was 79% (with a range of 53.7 to 100%) (Table 2). The two subjects with only two post-treatment collections also had 81.2 and 79.9% reduction in MBL respectively. The median absolute reduction in monthly blood loss was 98 mL per period per subject with a range of 39–185 mL. Individual reductions in MBL between pre- and during treatment are shown in Fig. 2. In 33 of 34 treatment cycles, blood loss had reduced to within the normal range (<80 mL).Table 2

View Article: PubMed Central - PubMed

ABSTRACT

Background: Heavy menstrual bleeding (HMB) exceeding 80&nbsp;mL per cycle leads to considerable adverse impact on a woman&rsquo;s iron metabolism, incidence of iron deficiency and anaemia, as well as her functioning in society.

Background: The objective of the study is to determine the potential efficacy of a Monophasic oestradiol-17&beta;-nomegestrol acetate (E2/Nomac) combined oral contraceptive pill on measured menstrual blood loss as a pilot study in 12 women with objectively demonstrated HMB (&gt;80&nbsp;mL per cycle). The pilot study aimed to recruit 20 women.

Method: Consented women completed the HMB questionnaire. The blood was taken for haemoglobin, transferrin, iron saturation, TIBC, serum iron and ferritin. Women were given verbal and written detailed instructions for MBL collection for three control cycles and four treatment cycles.

Results: Forty-three women were enrolled, but 31 were ineligible and withdrawn (mainly for failure to meet eligibility criteria). Twelve women entered the treatment phase and commenced the E2/nomegestrol acetate (NOMAC) 24/4 combined pill treatment on the first day of their fourth cycle. All women with complete MBL measurements had &gt;50% reduction in MBL on treatment (exact 95% confidence interval for proportion with MBL reduction &gt;50%: 69 to 100%). The mean percent reduction in MBL between pretreatment and during treatment was 76.9%, and the median was 79% with a range of 53.7 to 100%.

Conclusions: This pilot study indicates that the E2/NOMAC COC will provide a useful potential option for treating HMB in women with FIGO classification AUB-E (primary endometrial causes) but requires a larger placebo-controlled study for confirmation.

No MeSH data available.