The Use of Norethisterone for the Treatment of Severe Uterine Bleeding in Adolescents: An Audit of Our Experience

J Pediatr Adolesc Gynecol. 2019 Dec;32(6):596-599. doi: 10.1016/j.jpag.2019.09.002. Epub 2019 Sep 11.

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.

Keywords: AUB; Abnormal uterine bleeding; Adolescents; Heavy menstrual bleeding; Norethisterone.

MeSH terms

  • Adolescent
  • Child
  • Contraceptives, Oral, Hormonal / administration & dosage*
  • Female
  • Humans
  • Medical Audit
  • Menarche
  • Norethindrone / administration & dosage*
  • Prospective Studies
  • Treatment Outcome
  • Uterine Hemorrhage / drug therapy*

Substances

  • Contraceptives, Oral, Hormonal
  • Norethindrone