Sample Solution

Taru G et al[2] studied 70 women with levonorgesterol IUCD insertion for heavy menstrual bleeding which resulted in reduction in menstrual blood loss to 79% after 6 months of insertion. Improvement in haemoglobin levels from 8.16 to 9.35±0.7g% by 6 months.
There are no much studies conducted comparing oral ormeloxifene and levonorgesterol IUCD in the management of dysfunctional uterine bleeding.
In our study, no major side effects were seen with both oral ormeloxifene and levonorgesterol IUCD. Only 4 patients out of 40 treated with levonorgesterol IUCD had history of spotting pervagina.
In our study both oral ormeloxifene and levonorgesterol IUCD had significant reduction in pictorial blood loss assessment chart score , decrease in endometrial thickness and increase in haemoglobin concentration after treatment for 6 months in patients with dysfunctional uterine bleeding.
Both oral ormeloxifene and levonorgestrel IUCD treatment modalities were safe. Both were efficacious in treatment of dysfunctional uterine bleeding. No statistical significant differences between two treatment modalities were found.

CONCLUSION
Heavy menstrual bleeding or dysfunctional uterine bleeding is a very common gynecological problem. The options in management are wide and varied and often difficult to make a right choice as each one has their own merits and demerits. In the present day practice, hysterectomy has become obsolete for dysfunctional uterine bleeding and other minimally invasive techniques are costly. Hence medical management has become a choice of treatment in dysfunctional uterine bleeding. Most of the western guidelines recommend Levonorgestrel IUCD as first line of treatment. From our study we found both Ormeloxifene and Levonorgestrel IUCD are equally efficacious and safe. Hence both can be used for treatment particularly in perimenopausal women. Ormeloxifene is easy to administer and cheap. Levonorgestrel IUCD is costly but one time administration with few side effects like spotting, which makes patient apprehensive. Hence Ormeloxifene which is equally effective and cheap can be recommended for the treatment of dysfunctional uterine bleeding.