Mensil N° tablet is a preparation of Micronized Norethisterone, which has progestational actions similar to those of progesterone but is a more potent inhibitor of ovulation and has weak estrogenic and androgenic properties. It is used to treat various menstrual cycle disorders.
Norethisterone is absorbed from the gastrointestinal tract, and its effects last for at least 24 hours. It is excreted in the urine.
1. Dysfunctional Uterine Bleeding (DUB): Taking 1 tablet of Mensil N° three times daily for 10 days usually stops uterine bleeding (not caused by organic lesions) within 1–3 days. However, to ensure effective treatment, Mensil N° must be taken for the full 10 days.
After completing the treatment, withdrawal bleeding occurs 2–4 days later, similar in intensity and duration to normal menstruation.
Prophylaxis Against Recurrence of Dysfunctional Bleeding
To prevent recurrent dysfunctional bleeding in patients with anovulatory cycles, Mensil N° is recommended prophylactically:
1 tablet once or twice daily from day 16 to day 25 of the cycle (Day 1 = first day of last bleeding).
Withdrawal bleeding occurs a few days after stopping the medication.
2. Premenstrual Syndrome (PMS) & Mastopathy: 1 tablet of Mensil N° 1–3 times daily during the luteal phase of the cycle.
3. Timing of Menstruation: 1 tablet of Mensil N° 2–3 times daily for 10–14 days, starting about 3 days before the expected menstruation.
Withdrawal bleeding occurs 2–3 days after stopping the medication.
4. Endometriosis: Start treatment between day 1 and day 5 of the cycle with 1 tablet of Mensil N° twice daily.If spotting occurs, increase the dose to 2 tablets twice daily. If bleeding stops, return to the initial dose.
Duration of treatment: At least 4–6 months.
With uninterrupted daily intake, ovulation and menstruation do not usually occur. After discontinuation, withdrawal bleeding occurs.
5. Menorrhagia (Heavy Menstrual Bleeding): 1 tablet of Mensil N° three times daily from day 5 to day 25 of the cycle has been effective in reducing menstrual blood loss.
Circulatory Disorders
Epidemiological studies suggest that using oral estrogen-progestogen contraceptives is associated with increased thromboembolic risk. This risk should be considered, especially in patients with a history of thromboembolic disease.
Tumors
In rare cases, benign liver tumors and, more rarely, malignant liver tumors have been reported in users of hormonal substances such as Norethisterone.
In isolated cases, these tumors have caused life-threatening intra-abdominal hemorrhage.
Other Considerations
Diabetes: Strict medical supervision is required.
Chloasma: May occur, especially in women with a history of chloasma gravidarum.
Depression: Patients with a history of depression should be closely monitored, and the drug should be discontinued if severe depression recurs.
Use in Pregnancy: Contraindicated during pregnancy (US FDA Pregnancy Category X).
Use in Lactation: Mensil N° should not be used during breastfeeding.
Children: Safety and effectiveness in pediatric patients have not been established.
Geriatric Patients: No dosage adjustment is required, but caution is advised if the dose is increased.
Drugs that increase the clearance of sex hormones may reduce the effectiveness of Mensil N°. These include:
Hepatic enzyme inducers (e.g., phenytoin, barbiturates, primidone, carbamazepine, rifampicin)
Other suspected drugs: Griseofulvin, oxcarbazepine, rifabutin
Symptoms of overdose may include:
Nausea
Vomiting
Later vaginal bleeding
Store at a temperature not exceeding 30°C in a dry place.
Protect from light and moisture.
Keep out of reach of children.
