Micronised vaginal progesterone versus oral dydrogestrone in the treatment of dysfunctional uterine bleeding: efficacy and effects on lipid profile
Abstract
Purpose: The aim of this study was to compare the efficacy of short-course oral dydrogesterone versus vaginal micronized progesterone and to determine their effects on the lipid profile of the premenopausal women with dysfunctional uterine bleeding.
Materials and Methods: A total of 70 premenopausal women with dysfunctional uterine bleeding were randomly assigned to receive 90 mg of vaginal micronized progesterone (8% gel) (Group 1, n = 35) or 20 mg of oral dydrogesterone (Group 2, n = 35). The group 1 treatment consisted of self-application of vaginal progesterone, every other evening from the 17th to the 27th day of the menstrual cycle, for three cycles. The patients in Group 2 were treated with dydrogesterone 10 mg orally twice daily for 10 days, starting from the 15th day of the menstrual cycle, for three cycles.
Results: Body mass index increased significantly after three cycles of vaginal progesterone treatment whereas body mass index and serum LDL concentration increased significantly after three cycles of oral dydrogesterone treatment. The number of patients with secretory endometrium increased significantly after the completion of treatment in both groups.
Conclusion: Vaginal administration of micronized progesterone may be an alternative to oral progestins in the treatment of dysfunctional uterine bleeding. Vaginal micronized progesterone treatment seems to be as effective as oral progestin treatment and it also appears to have the advantage of easy application and no adverse effects on the lipid profile.
Kaynakça
- Referans1.Davidson BR, Dipiero CM, Govoni KD, Littleton SS, Neal JL. Abnormal uterine bleeding during the reproductive years. J Midwifery Womens Health. 2012; 57(3): 248-54.
- Referans2.Tsai MC, Goldstein SR. Office diagnosis and management of abnormal uterine bleeding. Clin Obstet Gynecol. 2012; 55(3): 635-50.
- Referans3.Bitzer J, Heikinheimo O, Nelson AL, Calaf-Alsina J, Fraser IS. Medical management of heavy menstrual bleeding: a comprehensive review of the literature. Obstet Gynecol Surv. 2015; 70(2): 115-30.
- Referans4.Hillard PA. Menstrual suppression: current perspectives. Int J Womens Health. 2014; 6: 631-7.
- Referans5.Schindler AE. Progestational effects of dydrogesterone in vitro, in vivo and on the human endometrium. Maturitas. 2009; 65 Suppl. 1: S3-11.
- Referans6.Karakus S, Kiran G, Ciralik H. Efficacy of micronised vaginal progesterone versus oral dydrogestrone in the treatment of irregulardysfunctional uterine bleeding: a pilot randomised controlled trial. Aust N Z J Obstet Gynaecol. 2009; 49(6): 685-8.
- Referans7.Royer PA, Jones KP. Progestins for contraception: modern delivery systems and novel formulations. Clin Obstet Gynecol. 2014; 57(4): 644-58.
- Referans8.Kostova P, Zlatkov V. Clinical study on the effect of vaginal administration of micronized progesterone at dysfunctional uterinebleeding in premenopause. Akush Ginekol (Sofiia). 2009; 48(2): 3-7.
- Referans9.Deligeoroglou E, Creatsas G. Menstrual disorders. Endocr Dev 2012; 22: 160-70.
- Referans10.Hickey M, Higham JM, Fraser I. Progestogens with or without estrogen for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev. 2012: 12; 9: CD001895.
