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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 12, Issue 2, September 2014 pp 276-279
Perimenopausal bleeding: evaluation of various treatment modalities
Sanjay Bansode1, Vinit Dhadke2
1Assistant Professor, 2Resident, Department of OBGY, SRTR Government Medical College, Ambajogai, Dist. Beed, Maharashtra, INDIA.
Introduction: Perimenopause is defined as, the years prior to menopause that encompasses the change from normal ovulatory cycles to cessation of menses, marked by irregularity of menstrual cycles. Management consists of a stepwise evaluation of all possible organic causes of uterine bleeding. A patient's degree of menorrhagia, associated pain, desire for pregnancy, concurrent medical conditions, treatment side effects and her physician's comfort level should be taken into account when deciding on management. Aims and objectives: to study the various treatment modalities used to treat perimenopausal bleeding. Materials and method: Women attending gynecology department with perimenopausal bleeding were enrolled in the study. Detail history, clinical finding were recorded. Treatment was decided using standard criteria. And the outcome was measured. Results: Maximum 66 i.e. 82.5% cases had dysfunctional uterine bleeding followed by fibroid. Majority of the cases (13.75%) had hypertension as associated disorder. 42 cases received Norethisterone acetate which cured 35 i.e. 83.33% cases, while 14 cases received Tranexamic acid which cured 12 i.e. 85.71% cases. In 12 cases dilatation and curettage was performed which cured 9 i.e. 75% cases, while in 12 cases hysterectomy was done which cured all the cases. 16.25% women required blood transfusion to correct the anemia. Conclusion: In medical management low cost tranexamic acid (85.75%) is almost as effective as high cost hormone therapy, norethisterone acetate (83.33%).Low cost minor surgical procedures like dilatation and curettage is effective in 75% cases while high cost major surgery like hysterectomy is effective in all the cases as it removes the causative organ.