Menorrhagia Clinical Trial
Official title:
Treatment of Non-Gestational Acute Uterine BleedingComparing Oral Medroxyprogesterone Acetate and Monophasic Oral Contraceptives Containing Norethindrone and Ethinyl Estradiol
To determine the relative efficacy of multidose medroxyprogesterone acetate (MPA, Provera) and a multidose, monophasic combination oral contraceptive in the treatment of hemodynamically stable women with non-gestational, acute uterine bleeding.
Acute uterine bleeding, unrelated to pregnancy, is a relatively common problem that causes
many reproductive-aged women to requite emergent medical and/or surgical intervention.
Although the traditional approaches have generally been surgical in nature, many
practitioners utilize medical methods to arrest the bleeding. However, despite widespread
use, there exists a paucity of information regarding the effectiveness, side-effects, and
patient satisfaction associated with the commonly-used medical regimens. (b) The purpose of
the study is to compare the efficacy of multidose medroxyprogesterone acetate and a
multidose, monophasic combined oral contraceptive in the treatment of hemodvnamically-stable
women with non-gestational, acute uterine bleeding.
(c) Non-pregnant, hemodynamically-stable, reproductive-aged, women, over the age of IS, who
present either to the emergency area or to KP practitioner's offices with acute uterine
bleeding, will be considered for eligibility. If, following a full exam and medically
appropriate investigations medical management is deemed appropriate, they will be approached
by a member of the investigating team for possible inclusion into the study. Following
informed consent, patients will be randomized to receive either medroxyprogesterone acetate
(20 mg three times daily for 7 days) or monophasic oral contraceptive containing I mg of
norethindrone and 35 ug of ethinyl estradiol (three dines daily for seven days). Following
the seven days of therapy, those randomized to MPA will continue with 20 mg per day for
three weeks while those randomized to oral contraceptives will take one pill per day for
three weeks, each completing a total of four weeks of therapy. The primary outcome will be
the number of days until cessation of bleeding. Other outcomes measured will include pad and
tampon counts, and hemoglobin levels. Chi square tests and student t will be used to
evaluate differences between the two treatment groups. The hope is that this study will
elucidate on the efficacy of the two regimens.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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