Abstract
Study Objective
The purpose of this prospective study was to assess the effectiveness of norethisterone
(NET) in the management of abnormal uterine bleeding (AUB) in adolescents in a tertiary
care center.
Design
This was a prospective audit focused on administering high doses of NET in female
adolescents with complaints of AUB.
Setting
We included female adolescents who presented to our Emergency Gynecological Department
or Adolescent Gynecological Outpatient Department from October 2016 to January 2019.
Participants
The study included 29 female adolescents aged 11-17 (mean, 13.14) years.
Interventions
Patients were administered a daily dose of 10-30 mg, depending on the severity of
the condition, bleeding duration, and patient weight.
Main Outcome Measures
Cessation of vaginal bleeding.
Results
Mean age at menarche of our patient sample was 11.4 years (range, 10.7-14 years).
AUB presented at a mean time of 24.6 months after menarche (range, 0-79 months). Blood
transfusion was deemed necessary in 9 patients. Bleeding stopped at a mean of 46.1
(range, 8-120) hours after onset of treatment with NET. No serious adverse events
were reported with NET administration, with only 3 cases of minor side effects.
Conclusion
The use of NET is an effective and reliable treatment option among adolescents for
whom control of AUB is desired in the acute setting.
Key Words
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References
- Management of abnormal uterine bleeding in adolescents.J Pediatr Adolesc Gynecol. 2010; 23: S22
- Practice guideline: evaluation and management of abnormal vaginal bleeding in adolescents.J Pediatr Health Care. 2009; 23: 189
- Evaluation and management of heavy menstrual bleeding in adolescents.Curr Opin Obstet Gynecol. 2017; 29: 328
- The quality of life in adolescents with menstrual problems.J Pediatr Adolesc Gynecol. 2013; 26: 102
- Treatment of acute abnormal uterine bleeding in adolescents: what are providers doing in various specialties?.J Pediatr Adolesc Gynecol. 2016; 29: 286
- Questionnaire study on menstrual disorders in adolescent girls in Singapore.J Pediatr Adolesc Gynecol. 2009; 22: 365
- Bleeding disorders among young women: a population-based prevalence study.Acta Obstet Gynecol Scand. 2006; 85: 200
- Randomised comparative trial of the levonorgestrel intrauterine system and norethisterone for treatment of idiopathic menorrhagia.Br J Obstet Gynaecol. 1998; 105: 592
- FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age.Int J Gynaecol Obstet. 2011; 113: 3
- American College of Obstetrics Gynecologists Committee on Adolescent Health Care: Menstruation in girls and adolescents: using the menstrual cycle as a vital sign.Pediatrics. 2006; 118: 2245
- Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data.Am J Obstet Gynecol. 2004; 190: 1216
- Evaluation and management of adolescents with abnormal uterine bleeding.Pediatr Ann. 2015; 44: 218
- U.S. medical eligibility criteria for contraceptive use, 2016.MMWR Recomm Rep. 2016; 65: 1
- ACOG Practice Bulletin No. 206: Use of hormonal contraception in women with coexisting medical conditions.Obstet Gynecol. 2019; 133: e128
- Management of heavy menstrual bleeding in adolescents.Curr Opin Obstet Gynecol. 2012; 24: 275
- Evaluation and treatment of menorrhagia in an adolescent population.J Min Invasive Gynecol. 2008; 15: 682
- Retrospective review of norethindrone use in adolescents.J Pediatr Adolesc Gynecol. 2014; 27: 41
- Oral medroxyprogesterone acetate and combination oral contraceptives for acute uterine bleeding: a randomized controlled trial.Obstet Gynecol. 2006; 108: 924
- High-dose medroxyprogesterone acetate for the treatment of dysfunctional uterine bleeding in 24 adolescents.Aust N Z J Obstet Gynecol. 1997; 37: 228
- Bayer New Zealand Limited: New Zealand Data Sheet.(Available:)https://www.medsafe.govt.nz/profs/datasheet/p/primolutntab.pdfDate accessed: September 28, 2019
Article info
Publication history
Published online: September 11, 2019
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2019 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Letter to the Editor: “The Use of Norethisterone for the Treatment of Severe Uterine Bleeding in Adolescents: An Audit of Our Experience”Journal of Pediatric and Adolescent GynecologyVol. 33Issue 3
- PreviewWe read the article by Papapanagiotou et al.1 concerning the treatment of abnormal uterine bleeding (AUB) using norethisterone (NET) with great interest. As the authors state, AUB is an important problem during adolescence and can be underreported until it causes symptomatic anemia. Due to the limited number of studies concerning the use of NET in adolescent girls for AUB, we believe this study is of importance, but we have concerns about why the authors have chosen NET as a first-line standard therapy for all AUB patients.
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