Evaluate the Effectiveness of Conservative Treatment for Menorrhagia in Women who were Admitted to the Shahid Sadoughi Hospital of Yazd-Iran in 2014-2015.
OBJECTIVE
Abnormal uterine bleeding is one of the most common debilitating menstrual problems. The first therapeutic strategy for abnormal uterine bleeding is drug treatment. This study was, therefore, designed to determine the efficacy of megestrol, medroxyprogesterone, GnRh agonist, Levonorgestrol IUD and endometrial ablation on bleeding and also to evaluate the side effects of each methods in patients with menorrhagia who were admitted to the Shahid Sadoughi clinic of Yazd University of Medical Sciences.


METHODS
Based on an analytical study with consideration of patients' medical history, 89 patients with age range of 25-50 years old were included. Each patient, under gynecologist supervision, received one of treatments for three month. The evaluation of patients bleeding in response to treatment were performed using a check list filled by patients and the results were compared before and after treatment. Medroxyprogesterone acetate, megestrol, GnRh agonist (Triptorelin embonate), Levonorgestrol IUD and endometrial ablation was used for patients as their characteristics. Each treatment was conducted for a period of 3 months. Megestrol 40 mg per day on an ongoing basis, medroxyprogesterone from 15th day of menstruation for 10 nights and Diphereline 3.75 mm (manufactured by Aria Health) were administered every 28 days. Mean of bleeding before and after treatment and complications of conservative therapy were evaluated. Statistical analysis of the data were performed using paired t test and Wilcoxon tests on spss-19 software.


RESULTS
Mean of age was 41.2 (25-50). Megestrol treatment with a frequency of 27% (24 patients) and endometrial ablation with a frequency of 20.2% (18 patients) were the most used therapy in this study. All of these ways of conservative treatment can decrease bleeding significantly. The complications of these methods of treatment were not significantly different. (p=0.37).Satisfaction of women after 2-3 months of treatment were increasing because spotting is common in the first months of therapy.


CONCLUSIONS
The results of this study indicate that all five methods are good enough to treat menorrhagia. All these methods can replace hysterectomy, especially in this age range in which preserve fertility is of particular importance, and patients can also be protected from hysterectomy, a heavy surgery, and surgery and post surgery complications.
Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
M
M
Karimi-Zarchi
Department of Midwifery, Lecturer Islamic Azad University, Shahrbabak brench, Iran.
M Zaid
MZ
Abadinezhad
Department of Midwifery, Islamic Azad University, Shahrbabak brench, Iran.
B
B
Bonyadpour
Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
S
S
Kabyrpour-Ashkezar
Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services Yazd, Iran.
A M
AM
Abhaji
GnRh agonist; Levonorgestrol IUD; conservative management; endometrial ablation; medroxyprogesterone; megestrol acetat; menorrhagia