AbstractBackground: To evaluate the efficacy and safety of COCPs v/s Norethisterone treatment in cases of heavy menstrual bleeding (HMB) by estimating the decrease in amount of blood loss during menses and improvement in quality of life of patients. Methods: This is an observational study conducted at PDMC attached to RNT Medical College, Udaipur in 2018. The women who fulfill the inclusion criteria were studied with respect to reproductive age group females with Heavy Menstrual Bleeding. Administration of OCPs (Mala-N) for 21 days starting from day 5 of cycle for 3 consecutive cycles and administration of oral progesterone (norethisterone) 5 mg TDS from D5 to D26 of menstrual cycle for 3 cycles was done. Results: Out of the total patients of heavy menstrual bleeding, majority were in the age group of 19-45 years i.e. 81.25%. Reduction in menstrual blood loss (MBL) is maximum with COCPs (70%). 55-60% patents improved haemoglobin with COCPs after 3 cycles of treatment. 71.4% of patients were relieved of dysmenorrhea, and 42.8% case of norethisterone. The side-effects reported were mainly epigastric pain, nausea, vomiting, headache and giddiness. COCPs improved QOL i.e. 75% and norethisterone (60%) which was almost equally effective. Reduction in menstrual blood loss was observed to be 36.7% (p<0.001) with norethisterone and 37.3% (p<0.001) with COCPs. There was improvement in mean haemoglobin levels after 3 treatment cycles with norethisterone (p=0.022) and COCPs (p=0.001). Conclusion: Both COCPs and norethisterone, are effective in reducing the PBAC score with COCPs being the most effective drug. COCPs was the most effective drug in improving the quality of life parameters and in improving the mean haemoglobin. It improved efficacy and safety in the treatment of heavy menstrual bleeding.