Evidence map›Paper›PMID 27134949›Full record

ArticleJournal of clinical and diagnostic research : JCDR2016

A Randomised Controlled Trial Comparing the Efficacy and Side-Effects of Intravaginal Ring (Nuvaring(®)) With Combined Oral Hormonal Preparation in Dysfunctional Uterine Bleeding.

Sandhya Jain, Neelam B Vaid, Yam Narang, Amita Suneja, Kiran Guleria

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical and diagnostic research : JCDR, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Combined hormonal contraceptives for heavy menstrual bleeding.The Cochrane database of systematic reviews · 2019
    Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Sandhya JainAssistant Professor, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital , Shahdara, Delhi, India .
Neelam B VaidProfessor, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital , Delhi, India .
Yam NarangSenior Resident, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital , Delhi, India .
Amita SunejaProfessor, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital , Delhi, India .
Kiran GuleriaProfessor, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital , Delhi, India .
University College of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCombined Oral Contraceptive (COC) pills are being used in patients of abnormal uterine bleeding, especially adolescents and reproductive age women considering their need for contraception. It decreases the blood loss due to haemostatic effect of estrogen and also regularizes the cycle. Intravaginal route has been found to be effective and acceptable; Gastrointestinal absorption and hepatic first-pass metabolism is avoided and steady, uniform blood concentration is achieved. Bioavailability of estrogen and progestogen through oral and vaginal route are same. The convenience of once-a-month administration is another major advantage. MATERIALS AND MATHODS: Sixty women fulfilling inclusion criteria were randomised into 2 groups in 1:1 ratio. In one group (n=30), monthly insertion of Nuvaring(®)) was done for three consecutive months. Nuvaring(®) releases 15μg ethinyl estradiol and 120 μg etonogesterol daily. The other group (n=30) received COC pill containing 30μg EE and 150 μg levonorgestrel for three consecutive months. Primary outcome measures were change in menstrual cycle pattern and pictorial Blood Loss Assessment chart (PBAC) score. Other Parameters included side effects, change in haemoglobin and weight. Data was analyzed by statistical software SPSS 20.

resultsBoth Nuvaring(®) and COC were found to significantly decrease blood loss in each cycle. Decrease in PBAC score was more in Nuvaring(®) group compared to COC, however difference was not significant. Ideal bleed (IB) was frequently higher for Nuvaring(®) group than COC in all 3 cycles, although no statistically significant difference was observed between groups (p-value=0.286). Late withdrawl, intermenstural spotting was higher in COC group. Compliance was better and women were more satisfied in Nuvaring(®) group compared to COC group. Minor side effects like headache, mastalgia, nausea and mood changes were seen in both groups, which were not significant. Continuation rate was significantly higher in Nuvaring® group. 30% women discontinued treatment in OCP group after 3 month compare to 10% in Nuvaring(®) group.

conclusionPresent study shows Nuvaring(®) to be as effective as COC in controlling heavy menstural bleed, better cycle control, with minor acceptable systemic side effects.

Indexed as

Abnormal uterine bleedingCycle controlNuvaringOral contraceptive pills

Identifiers

PMID27134949
PMCPMC4843334
OpenAlexW2339383574

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.