Retrospective Review of Norethindrone Use in Adolescents

Study ObjectiveOur objectives were to review norethindrone use in an adolescent population in a tertiary care center and to assess the effectiveness of the norethindrone taper in the management of acute heavy menstrual bleeding in adolescents.DesignRetrospective cohort study.SettingTertiary care center.Participants176 adolescent females prescribed norethindrone 0.35 mg between July 2007 and September 2010.InterventionsNone.Main Outcome MeasuresDiscontinuation and irregular bleeding rates.ResultsMean age was 14.8 ± 2.3 years. Most common indication for use was heavy menstrual bleeding (32.9%). Most common reasons for use of a progestin only pill were neurologic (27.8%) and cardiovascular diseases (17.6%). Discontinuation rate was 48.5%, most commonly for irregular bleeding (54.5%). Irregular bleeding and systemic side effects were associated with discontinuation (P = .006 and .003 respectively). No serious adverse events were reported. Twenty patients required norethindrone taper for heavy bleeding; of this group 78.9% experienced complete cessation of bleeding within 7 days.ConclusionsOur findings support use of norethindrone as an effective alternative among adolescents with contraindications to administration of estrogen and for whom control of acute heavy menstrual bleeding is desired.