Santos M, Hendry Deborah, Sangi-Haghpeykar Haleh, Dietrich Jennifer E
Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
J Pediatr Adolesc Gynecol. 2014 Feb;27(1):41-4. doi: 10.1016/j.jpag.2013.09.002. Epub 2013 Dec 4.
Our objectives were to review norethindrone use in an adolescent population in a tertiary care center and to assess the effectiveness of the norethindrone taper in the management of acute heavy menstrual bleeding in adolescents.
Retrospective cohort study.
Tertiary care center.
176 adolescent females prescribed norethindrone 0.35 mg between July 2007 and September 2010.
None.
Discontinuation and irregular bleeding rates.
Mean age was 14.8 ± 2.3 years. Most common indication for use was heavy menstrual bleeding (32.9%). Most common reasons for use of a progestin only pill were neurologic (27.8%) and cardiovascular diseases (17.6%). Discontinuation rate was 48.5%, most commonly for irregular bleeding (54.5%). Irregular bleeding and systemic side effects were associated with discontinuation (P = .006 and .003 respectively). No serious adverse events were reported. Twenty patients required norethindrone taper for heavy bleeding; of this group 78.9% experienced complete cessation of bleeding within 7 days.
Our findings support use of norethindrone as an effective alternative among adolescents with contraindications to administration of estrogen and for whom control of acute heavy menstrual bleeding is desired.
我们的目标是回顾三级医疗中心青少年人群中炔诺酮的使用情况，并评估炔诺酮逐渐减量法在治疗青少年急性月经过多方面的有效性。
回顾性队列研究。
三级医疗中心。
2007年7月至2010年9月期间176名开具了0.35毫克炔诺酮处方的青春期女性。
无。
停药率和不规则出血率。
平均年龄为14.8±2.3岁。最常见的用药指征是月经过多（32.9%）。仅使用孕激素避孕药最常见的原因是神经系统疾病（27.8%）和心血管疾病（17.6%）。停药率为48.5%，最常见的原因是不规则出血（54.5%）。不规则出血和全身副作用与停药相关（分别为P = 0.006和0.003）。未报告严重不良事件。20名患者因月经过多需要逐渐减量使用炔诺酮；在该组中，78.9%的患者在7天内出血完全停止。
我们的研究结果支持将炔诺酮作为雌激素给药有禁忌且希望控制急性月经过多的青少年的有效替代药物。
