Effect of oral administration of a continuous 18 day regimen of meloxicam on ovulation: experience of a randomized controlled trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 24909636 · doi:10.1016/j.contraception.2014.04.011
What was done
Healthy sterilized women (n = 56) with confirmed ovulatory cycles (serum progesterone > 12 nmol/L) were randomized to receive oral meloxicam at 15 mg/day or 30 mg/day for 18 continuous days (menstrual cycle days 5 to 22) across three consecutive cycles. Menstrual cycles were monitored with serial ultrasound and blood hormone assays during a pre-treatment control cycle, three treatment cycles, and a post-treatment control cycle.
What was found
All 56 enrolled participants completed the study. Dysfunctional ovulation occurred in 55% of cycles with 15 mg/day and in 78% of cycles with 30 mg/day (p < 0.001). Normal ovulation was observed in 44.6% of cycles in the 15 mg/day group and in 21.7% of cycles in the 30 mg/day group. No serious adverse events occurred, and adverse events did not differ significantly between doses or between control and treated cycles.
Why it matters
While extended mid-cycle meloxicam suppresses and disrupts normal ovulation in a dose-dependent manner, persistent ovulation in over 20% of cycles at 30 mg/day indicates it is not viable as a primary non-hormonal contraceptive method.
Limits
The trial had a small sample size (n = 56). All participants were surgically sterilized, precluding direct assessment of pregnancy rates, and the trial only evaluated three consecutive treatment cycles.
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