Selective estrogen receptor modulator: efficacy in abnormal uterine bleeding in perimenopausal women


  • Ankita Mani Department of Obstetrics and Gynecology, AIIMS, Patna, Bihar, India
  • Kanchan Sharma Department of Pathology, NMCH, Patna, Bihar, India
  • Arun Kumar Department of Pathology, NMCH, Patna, Bihar, India
  • R. K. Talukdar Department of Obstetrics and Gynecology, GMCH, Guwahati, Assam, India



Abnormal uterine bleeding, Dilatation and curettage, Early reproductive age, ET endometrial thickness, Ormeloxifene, Pictorial blood loss assessment chart score (PBAC), Selective estrogen receptor modulators


Background: Abnormal uterine bleeding affects 50% women of perimenopausal age group. The use of ormeloxifene (SERMS) in management of AUB is well known. The objective of the present study was aimed to see the effects of ormeloxifene on different types of the medical management of Abnormal Uterine Bleeding (AUB).

Methods: It was Prospective, interventional study. A total of 90 women who attended Outpatient Gynaecology Department, Guwahati with complain of AUB in perimenopausal age group (37-48) were prescribed 60mg ormeloxifene twice weekly for 3 months followed by once weekly for next 3 months after preliminary D and C.

Results: Ormeloxifene was found to be more effective in reducing PBAC score and ET in patients with proliferative and secretory endometrium The reduction in mean PBAC score with ormeloxifene (175.3 to 20.93)(p value 0.0001) and ET (9.6 to 2.9 mm) (p value 0.0001) in proliferative endometrium, (179.2 to 14.8 (p value 0.0001) ) and ET 11.1 to 1.9 mm (p value 0.0003)in secretory endometrium was observed after 6 months. However, it was found not to be effective in reducing PBAC score and ET in patients with atrophic endometrium. Change in PBAC SCORE from 176.4 to 150.8 (p value 0.08) and in ET from 2.8 to 2.1mm( p value 0.3) was observed. No major side effects were reported.

Conclusions: Ormeloxifene is effective in AUB with proliferative and secretory endometrium.


Bhatia N. Abnormal and Excessive Uterine Bleeding. In Neeraj Bhatia editor. Jeffcoate's Principles of Gynaecology. 5th Edition. London: Arnold Publishers; 2001. p.560

Fleischer AC, Kalemeris GC, Entman SS. Sonographic depiction of the endometrium during normal cycles. Ultras Med Biol. 1986;12(4):271-7.

Prentice A. When does heavy flow merit treatment? The Pract. 2000;244(1608):174.

Fraser IS. Treatment of ovulatory and anovulatory dysfunctional uterine bleeding with oral progestogen. Aus NZ J Obstet Gynaecol. 1990;30(4):353-6.

Kriplami A, Kulshrestha V, Agarwal N. Efficacy and safety of ormeloxifene in the management of menorrhagia: A pilo pilot study. J Obstet Gynecol Res. 2009;35(4):746-52.

Higham JM, O'brien PM, Shaw RW. Assessment of menstrual blood loss using a pictorial chart. BJOG: Int J Obstet Gynaecol. 1990;97(8):734-9.

Mandal D, Parmanik S, Surana S, Hazra A, Mandal S, Maity TK. Comparative Study of Ormeloxifene verses OCPs in management of DUB. International J Health Allied Sci. 2014;4(3):225-31.

Shahab SF, Jain S, Jain J, Jain U. Ormeloxifene: boon to perimenopausal dysfunctional uterine bleeding (DUB) women in avoiding hysterectomies. Int J Med Sci Education. 2014;1(1):21-9.

BelladGirija C, Lakshmi KS. Ormeloxifene in the Management of Dub. J Evid based Med Health. 2015; 2(37):6125-31.

Grover S, Chhabra A, Sainath B. A Study of Ormeloxifene in case of Dysfunctional uterine bleeding. Int J Med Dent Sci. 2013;1(2):162-9.

Ravibabu K, Palla J, Chintada GS. A study of efficacy of ormeloxifene in the pharmacological management of dysfunctional uterine bleeding. J Clin Diag Res. 2013;7(11):2534.

Agarwal N, Singh S, Singh S, Agarwal M, Manocha P. Comparative evaluation of the efficacy and safety of ormeloxifene and norethisterone in dysfunctional uterine bleeding. Int J Reproduct, Contracep, Obstet Gynecol. 2013; 2(2):194-8.

Shravage J, Mekhala D, Bellad MB Ormeloxifene vs MPA in treatment of DUB. J South Asian Fed Obstet Gynaecol. 2011;3(1):21-4

Hymavathi K, Gottipati MD, Prasuna SV. Ormeloxifene versus Tranexamic acid in dysfunctional uterine bleeding comparative evaluation. Int J Reproduct, Contracep, Obstet Gynecol;7(2):567.






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