title: Potentially effective therapy of heavy menstrual bleeding with an oestradiol-nomegestrol acetate oral contraceptive: a pilot study.
abstract: BACKGROUND
  Heavy menstrual bleeding (HMB) exceeding 80 mL per cycle leads to considerable adverse impact on a woman's iron metabolism, incidence of iron deficiency and anaemia, as well as her functioning in society. The objective of the study is to determine the potential efficacy of a Monophasic oestradiol-17β-nomegestrol acetate (E2/Nomac) combined oral contraceptive pill on measured menstrual blood loss as a pilot study in 12 women with objectively demonstrated HMB (>80 mL per cycle). The pilot study aimed to recruit 20 women.
  
  
  METHODS
  Consented women completed the HMB questionnaire. The blood was taken for haemoglobin, transferrin, iron saturation, TIBC, serum iron and ferritin. Women were given verbal and written detailed instructions for MBL collection for three control cycles and four treatment cycles.
  
  
  RESULTS
  Forty-three women were enrolled, but 31 were ineligible and withdrawn (mainly for failure to meet eligibility criteria). Twelve women entered the treatment phase and commenced the E2/nomegestrol acetate (NOMAC) 24/4 combined pill treatment on the first day of their fourth cycle. All women with complete MBL measurements had >50% reduction in MBL on treatment (exact 95% confidence interval for proportion with MBL reduction >50%: 69 to 100%). The mean percent reduction in MBL between pretreatment and during treatment was 76.9%, and the median was 79% with a range of 53.7 to 100%.
  
  
  CONCLUSIONS
  This pilot study indicates that the E2/NOMAC COC will provide a useful potential option for treating HMB in women with FIGO classification AUB-E (primary endometrial causes) but requires a larger placebo-controlled study for confirmation.
authors.affiliation: Family Planning NSW, 328-336 Liverpool Road, Ashfield, Sydney, NSW 2131 Australia.|University of Sydney, Sydney, Australia.
authors.forename: Edith
authors.identifier: 0000-0002-8485-194X
authors.initials: E
authors.lastname: Weisberg
authors.affiliation: Family Planning NSW, 328-336 Liverpool Road, Ashfield, Sydney, NSW 2131 Australia.|University of Sydney, Sydney, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: McGeehan
authors.affiliation: Family Planning NSW, 328-336 Liverpool Road, Ashfield, Sydney, NSW 2131 Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Hangan
authors.affiliation: University of New South Wales, Sydney, Australia.
authors.forename: Ian S
authors.initials: IS
authors.lastname: Fraser
keywords: Heavy menstrual bleeding (HMB); Menstrual pain; Menstruation; Quality of life (QoL); Survey