Comparison of Intramuscular Dose of Progesterone with Oral Progesterone in Heavy Menstrual Bleeding
DOI:
https://doi.org/10.70749/ijbr.v3i7.2184Keywords:
Intramuscular progesterone, Oral progesterone, Menorrhagia, Efficacy, EndometriumAbstract
Objective: To compare the efficacy of oral and intramuscular progesterone in women with heavy menstrual bleeding presenting at tertiary care hospital. Methodology: The aim of this investigation was to rigorously assess the comparative impacts of oral versus intramuscular administration of progesterone in a cohort of females aged 18 to 49 experiencing significant menstrual hemorrhage; this study was undertaken at the Department of Obstetrics and Gynaecology, Sheikh Zayed Woman Hospital, SMBBMU, Larkana, during the period from November, 2024 to April, 2025. Subjects were systematically assigned to receive either oral or intramuscular progesterone through a randomized protocol across three distinct cycles. The assessment of therapeutic efficacy was performed at the three-month interval. The data obtained were analyzed through the software SPSS version 26.0, considering P ≤ 0.05 as significant. Results: The average age of the subjects was 31.13 ± 7.85 years in the oral administration group, and 32.81 ± 7.56 years in the intramuscular group. The therapeutic effectiveness was observed in 37.7% of females who were given oral progesterone, in contrast to just 15.1% of those who were treated with intramuscular progesterone. This observed variance was determined to be statistically significant (p = 0.008). Conclusion: Current findings reveal that oral progesterone shows significantly enhanced effectiveness relative to intramuscular progesterone in addressing menorrhagia among women within the reproductive age group. In light of its superior effectiveness and convenient administration, oral progesterone ought to be regarded as a preferential therapeutic modality. These results furnish empirically supported guidance for the judicious selection of the most advantageous route of progesterone therapy within clinical practice.
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References
1. National Institute for Health and Care Excellence (NICE). Heavy menstrual bleeding: assessment and management. NICE guideline [NG88]. London: NICE; 2018.
2. Hallberg L, Högdahl AM, Nilsson L, Rybo G. Menstrual blood loss—a population study. Acta Obstet Gynecol Scand. 1966;45(3):320–351.
https://doi.org/10.3109/00016346609158455
3. Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM–COEIN) for causes of abnormal uterine bleeding. Int J Gynaecol Obstet. 2011;113(1):3–13.
https://doi.org/10.1016/j.ijgo.2010.11.011
4. Fraser IS, Langham S, Uhl-Hochgraeber K. Health-related quality of life and economic burden of abnormal uterine bleeding. Expert Rev Obstet Gynecol. 2009;4(2):179–189.
https://doi.org/10.1586/17474108.4.2.179
5. Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and healthcare costs and utilization in abnormal uterine bleeding. Value Health. 2007;10(3):183–194.
https://doi.org/10.1111/j.1524-4733.2007.00168.x
6. Critchley HO, Babayev E, Bulun SE, et al. Menstruation: science and society. Am J Obstet Gynecol. 2020;223(5):624–664.
https://doi.org/10.1016/j.ajog.2020.06.004
7. McEvoy M, Franks S. The pharmacokinetics and metabolism of progesterone. Clin Obstet Gynecol. 1983;26(1):58–72.
8. Stanczyk FZ. All progestins are not created equal. Steroids. 2003;68(10–13):879–880.
https://doi.org/10.1016/j.steroids.2003.08.003
9. Bouchard P. Endometrial effects of progestins. Maturitas. 2004;47(4):273–276.
10. Lethaby A, Hussain M, Rishworth JR, Rees MC. Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding. Cochrane Database Syst Rev. 2015;(4):CD002126.
https://doi.org/10.1002/14651858.cd002126.pub3
11. Kaunitz AM, Meredith S, Inki P, Kubba A, Sanchez-Ramos L. Levonorgestrel-releasing intrauterine system and endometrial pathology in women with abnormal uterine bleeding: a systematic review. Obstet Gynecol. 2009;113(5):1104–1111.
https://doi.org/10.1097/aog.0b013e3181a1d3ce
12. Deligeoroglou E, Creatsas G. Management of dysfunctional uterine bleeding. Best Pract Res Clin Obstet Gynaecol. 2010;24(6):747–761.
13. Abdel-Aleem H, d'Arcangues C, Vogelsong KM, Gaffield ME. Treatment of heavy menstrual bleeding with progestogens: a systematic review. BJOG. 2007;114(7):879–885.
https://doi.org/10.1002/14651858.cd003449.pub4
14. Yildiz Y, Yildiz A, Kadioglu BG. Oral versus vaginal micronized progesterone in the treatment of abnormal uterine bleeding. Arch Gynecol Obstet. 2012;286(6):1315–1321.
15. Abdel-Aleem H, d’Arcangues C, Vogelsong KM, Gaffield ME. Treatment of heavy menstrual bleeding with progestogens: a systematic review. BJOG. 2007;114(7):879–885.
https://doi.org/10.1002/14651858.cd003449.pub4
16. Matteson KA, Clark MA. Questioning our questions: do we assess menstrual bleeding in the best way? J Womens Health (Larchmt). 2010;19(6):1107–1111.
https://doi.org/10.1080/03630241003705037
17. Shankar M, Lee CA, Sabin CA, Economides DL, Kadir RA. von Willebrand disease in women with menorrhagia: a systematic review. BJOG. 2004;111(7):734–740.
https://doi.org/10.1111/j.1471-0528.2004.00176.x
18. Dhont M. Clinical use of progestogens. Maturitas. 2010;65 Suppl 1: S4–S11.
19. Kaunitz AM. Long-acting injectable depot medroxyprogesterone acetate contraception: an update for U.S. clinicians. Int J Womens Health. 2011; 3:139–147.
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