Continues Norethisterone Acetate versus Cyclical Drospirenone 3 mg/ethinyl Estradiol 20 μg for the Management of Primary Dysmenorrhea
in Young Adult Females.


Moamar Al-Jefout, MD, PhD, Nedal Nawaiseh, MD, PhD


Objective: To evaluate the efficacy of continues Norethisterone acetate, 5 mg (NET-A; group N) versus cyclical combined oral contraceptive pill (COC) consisting of drospirenone 3 mg/ethinyl estradiol 20 μg pills (group P) in treating dysmenorrhea in young adult females. Study design: This prospective, open-label, non-randomized study included 38 patients: 20 patients (Group N) and 18 patients (Group P). Interventions: Continuous NET-A 5mg daily or cyclical COC. Main Outcome Measures:Pain scores, adverse effects, analgesics use, school absence and cost. Results:38 patients initiated NET-A or COC for 6 months. All participants had almost the same starting levels of VAS scores. Both drugs were similar in suppressing dysmenorrhea at the 3 months follow up visit; VAS score means (± SD) in Group N and P were 1.30± 1.22 and 1.28± 0.83 (p value 0.22), as well as after 6 months, with VAS score means (± SD) 1.30± 1.22 and 1.28± 0.83 respectively (p-value 0.95). The cost of the treatment in the N group was much less than the P group. Participants in the N group were less likely to use pain killers: 20% and 44 % in the N and P groups respectively (p value 0.006) in the first month and only 5 % and 17 % (p value 0.019) in the N and P respectively at the 3 months and none of them used any analgesics at the 6 months. Conclusion: Continuous NET-A regimen is a well-tolerated, effective and cheap option for dysmenorrhea treatment and was as good as COC

Keywords: Primary Dysmenorrhea, Young adult females, Norethisterone acetate, Combined oral contraceptive pill


American Journal of Pediatric and Adolescent Gynecology.

Received: July 21, 2015; Accepted: August 27, 2015; Published Online: September 02, 2015