Comparison of Efficacy of Norethisterone (Primolut-N) Between Twice or Thrice Daily Dose to Avoid Menstrual Bleeding During Hajj and Umrah

Abstract

Objective:  To compare the efficacy between twice and thrice dosage of norethisterone to avoid menstrual bleeding during Hajj and Umrah.  Study Setting: Gynaecology OPD (Pakistan Air Force Hospital Mushaf Sargodha).

Duration of Study: The study was conducted for a period of two years from 01.1.2015 to 31.12.2016.

Study Design: This was an Interventional comparative study.

Methodology: One hundred and seventy-eight women, going to perform Hajj or Umrah were selected for this study purpose. A detailed history was taken and the women were examined with the help of Cusco’s speculum, bimanual pelvic examination and one step diagnosis by transvaginal ultrasound. The women were given different doses of norethisterone and were divided in three groups. Group I was given 5 mg BD dosage. Group II was given norethisterone 5 mg in TDS dose and group III used 10 mg BD dose. They were also advised to start the medicine ten or fifteen days before menstruation and to continue it throughout their stay at Saudi Arabia. They were advised to come for follow up after their arrival in Pakistan. There were 178 women among whom 150 women came for follow up. On arriving in Pakistan, the problems of bleeding were noted.  

Results:  The best response was seen with 10mg dose BD when it was started 10-15 days before the menstruation. While 5 mg BD dose of Norethisterone was not effective in about 50% if women. Similarly, 5 mg TDS dose was equally effective if started 10-15 days before next menstruation

Conclusion:  Norethisterone is an effective for prolongation of menstrual bleeding in special events like Hajj and Umrah. Best results are achieved when it is started 15 to 10 days before next menstrual cycle and given in 15mg to 20 mg daily dosage.