The use of norethisterone to suppress menstruation in the intellectually severely retarded woman.
Norethisterone (17-beta-hydroxy-19-norpreg-4-en-20yn-3-one), a 19 norsteroid with a potent progestogenic, some androgenic, some anabolic, and negligible estrogenic activity, was given in oral doses of 5 mg/day to 118 nulliparous women for 2 to 30 months. All women had previously menstruated, and were incapable of coping with their menses. This dosage was effective in producing amenorrhea in 86% of the women. Breakthrough bleeding occurred in 14.4% of the patients and tended to recur in these patients at intervals of 1-2 months. Bleeding was usually not heavier than a normal period. The breakthrough bleeding continued when the dose was raised to 10 mg/day. Weight gain, hirsutism, acne, headache, nausea and vomiting did not appear to increase in incidence in those taking norethisterone. Improved behavior was noted in some patients. The metabolic effects and some of the possible dangers of long-term norethisterone therapy are discussed.