title: Contraceptive vaginal ring treatment of heavy menstrual bleeding: a randomized controlled trial with norethisterone.
abstract: BACKGROUND
  This study compared the efficacy of the contraceptive vaginal ring (CVR; NuvaRing; N.V. Organon, Oss, the Netherlands) and norethisterone for treatment of idiopathic heavy menstrual bleeding (HMB) during the fertile age.
  
  
  METHODS
  Ninety-five women with idiopathic HMB were selected in this randomized controlled trial. They were treated with either the CVR (n=48) or norethisterone (n=47) for three cycles. Each cycle consisted of 3 weeks of CVR use and then a 1-week ring-free period or norethisterone tablets, 5 mg three times daily from Cycle Days 5 to 26. Outcome measures were as follows: menstrual blood loss assessed by pictorial blood loss assessment chart (PBAC), duration of menses, hemoglobin, serum ferritin, quality of life (QoL) questionnaire, side effects and overall satisfaction with treatment.
  
  
  RESULTS
  Significant improvements in PBAC score, the duration of menses, hemoglobin, serum ferritin and QoL were observed at the end of the study in each group. No statistically significant differences were found regarding the mean PBAC score (90.2±24.4 vs. 92.3±26.7) and its percent reduction (68.6% vs. 69.5%), duration of menses (5.3±1.2 vs. 5.5±1.1 days), hemoglobin and serum ferritin at the end of the study between the CVR and the norethisterone groups, respectively. Significantly more ring users were satisfied and elected to continue with treatment.
  
  
  CONCLUSIONS
  Both the CVR and oral norethisterone are effective treatments for idiopathic HMB. The CVR may be an attractive option especially for those requesting contraception as well.
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. hatem_ah@hotmail.com
authors: Hatem
authors: H
authors: Abu Hashim
authors: Waleed
authors: W
authors: Alsherbini
authors: Mohamed
authors: M
authors: Bazeed
mesh_terms: D000328:Adult; D003274:Contraceptive Devices, Female; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage*; D017135:Desogestrel / Q000031:analogs & derivatives; D004338:Drug Combinations; D004997:Ethinyl Estradiol; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000188:drug therapy*; D009640:Norethindrone / Q000008:administration & dosage*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D055815:Young Adult
chemical_list: D003280:Contraceptives, Oral, Synthetic; D004338:Drug Combinations; C516519:NuvaRing; D004997:Ethinyl Estradiol; D017135:Desogestrel; D009640:Norethindrone