title: Retrospective review of norethindrone use in adolescents.
abstract: OBJECTIVE
  Our objectives were to review norethindrone use in an adolescent population in a tertiary care center and to assess the effectiveness of the norethindrone taper in the management of acute heavy menstrual bleeding in adolescents.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  176 adolescent females prescribed norethindrone 0.35 mg between July 2007 and September 2010.
  
  
  METHODS
  None.
  
  
  METHODS
  Discontinuation and irregular bleeding rates.
  
  
  RESULTS
  Mean age was 14.8 ± 2.3 years. Most common indication for use was heavy menstrual bleeding (32.9%). Most common reasons for use of a progestin only pill were neurologic (27.8%) and cardiovascular diseases (17.6%). Discontinuation rate was 48.5%, most commonly for irregular bleeding (54.5%). Irregular bleeding and systemic side effects were associated with discontinuation (P = .006 and .003 respectively). No serious adverse events were reported. Twenty patients required norethindrone taper for heavy bleeding; of this group 78.9% experienced complete cessation of bleeding within 7 days.
  
  
  CONCLUSIONS
  Our findings support use of norethindrone as an effective alternative among adolescents with contraindications to administration of estrogen and for whom control of acute heavy menstrual bleeding is desired.
authors: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. Electronic address: xmsantos@texaschildrens.org.
authors: M
authors: M
authors: Santos
authors: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors: Deborah
authors: D
authors: Hendry
authors: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors: Haleh
authors: H
authors: Sangi-Haghpeykar
authors: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors: Jennifer E
authors: JE
authors: Dietrich
mesh_terms: D000293:Adolescent; D002648:Child; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage* / Q000009:adverse effects; D000075202:Contraindications; D004967:Estrogens; D005260:Female; D019584:Hot Flashes / Q000139:chemically induced; D006801:Humans; D055118:Medication Adherence; D008595:Menorrhagia / Q000188:drug therapy*; D008796:Metrorrhagia / Q000139:chemically induced*; D019964:Mood Disorders / Q000139:chemically induced; D009325:Nausea / Q000139:chemically induced; D009640:Norethindrone / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016312:Treatment Refusal; D014839:Vomiting / Q000139:chemically induced
chemical_list: D003280:Contraceptives, Oral, Synthetic; D004967:Estrogens; D009640:Norethindrone
keywords: Adolescents; Heavy menstrual bleeding; Norethindrone; Progestin only pill; Taper