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

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dc.contributor.authorSaha, Tarnimaen_US
dc.contributor.authorBharadwaj, Meenakshi K.en_US
dc.contributor.authorVardhan, Shaktien_US
dc.date.accessioned2020-10-16T08:03:08Z
dc.date.available2020-10-16T08:03:08Z
dc.date.issued2020-03
dc.description.abstractBackground: 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.en_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, Armed Forces Medical College, Pune, Maharashtra, Indiaen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, Military Hospital, Devlali, Nashik, Maharashtra, Indiaen_US
dc.identifier.citationSaha Tarnima, Bharadwaj Meenakshi K., Vardhan Shakti. 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. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020 Mar; 9(3): 1205-1212en_US
dc.identifier.issn2320-1770
dc.identifier.issn2320-1789
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/207528
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber3en_US
dc.relation.volume9en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-1770.ijrcog20200901en_US
dc.subjectCombined oral contraceptive pillsen_US
dc.subjectHeavy menstrual bleedingen_US
dc.subjectIntravaginal hormonal ringen_US
dc.subjectPictorial blood loss assessment charten_US
dc.titleA randomized controlled trial to study the efficacy of intravaginal hormonal ring for control of heavy menstrual bleeding as compared to combined oral contraceptive pillsen_US
dc.typeJournal Articleen_US
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