Uterine bleeding

Comphcations associated with lUDs include uterine perforation and pelvic inflammatory disease (95). Uterine bleeding and cramping are the most common causes for discontinuation of this method. 

The progestins are used in the treatment of amenorrhea, endometriosis, and functional uterine bleeding. Progestins are also used as oral contraceptives, either alone or in combination with an estrogen (see the Summary Drug Table Female Hormones and Table 52-1). 

Ergonovine and methylergonovine both increase the strength, duration, and frequency of uterine contractions and decrease the incidence of uterine bleeding. They are given after the delivery of the placenta and are used to prevent postpartum and postabortal hemorrhage caused by uterine atony (marked relaxation of the uterine muscle). 

O Heavy smokers (greater than or equal to 15 cigarettes per day) over the age of 35, as well as patients with a history of thromboembolic disease, stroke, coronary artery disease, any estrogen-dependent neoplasm, or undiagnosed abnormal uterine bleeding, should not take estrogen-containing contraceptives. 

History of any estrogen-dependent neoplasm Undiagnosed abnormal uterine bleeding Pregnancy (known or suspected)... 

There are potential side effects of IUD use. The most common adverse effects are cramping, abnormal uterine bleeding, and expulsion of the device. Other side effects seen are ectopic pregnancy, sepsis, PID, embedment of the device, uterine or cervical perforation, and ovarian cysts.40,41... 

Anovulatory bleeding, also referred to as dysfunctional uterine bleeding, is secondary to the effects of unopposed estrogen and does not include bleeding owing to an anatomic lesion of the uterus. 

Anovulatory bleeding is the most common form of non-cyclic uterine bleeding.11 Patients often seek medical care to regulate... 

Stenchever MA, Droegemueller W, Herbst AL, Mishell DR. Abnormal uterine bleeding Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In Stenchever MA, ed. Comprehensive Gynecology. 4th ed. St. Louis Mosby 2001 1079-1097. 

SUI. Systemic estrogen therapy also carries numerous short- and long-term side effect risks (mastodynia, uterine bleeding, nausea, thromboembolism, cardiac and cerebrovascular ischemic events, and enhanced breast and endometrial cancer risks). If estrogens are to be used in SUI management, only locally-administered products should be used (Table 50-4). 

Dysfunctional uterine bleeding may occur during perimenopause. 

Elimination of uterine bleeding. Reduced endometrial cancer risk... 

No significant effect was observed on endometrial thickness or on the length and severity of uterine bleedings after raloxifene treatment at doses of 60 and 180 mg/d in premenopausal women (Palomba et al. 2002a). Unfortunately,... 

Progestins are nsed for varions menstmal cycle disorders, for functional uterine bleeding of various origins, and as a contraceptive. Progestin therapy is also used to treat endometriosis and endometrial carcinomas. Progesterone is not effective when taken orally due to intensive metabolism, and therefore it is used by either parenteral or transvaginal introduction. 

This drug can be used as a carboxylic acid ester, in particular, as an acetate. It causes the mucous membranes of the uterus to move into the secretory phase, which facilitates development of impregnated oocytes. It reduces the excitability and contractility of uterine musculature. It is used for amenorrhea, uterine bleeding, infertility, miscarriage, myoma, mastopathy, endometrial cancer, and other pathologies. Synonyms of this drug are conce-plan, norfor, brevinor, and many others. 

Abnormal uterine bleeding caused by hormonal imbalance in the absence of organic pathology - Usual dose is one 25 mg injection IV or IM. Repeat in 6 to 12 hours if necessary. Inject slowly to obviate the occurrence of flushes. 

Excessive estrogenic stimulation Certain patients may develop undesirable manifestations of excessive estrogenic stimulation (eg, abnormal or excessive uterine bleeding, mastodynia). Advise the pathologist of estrogen therapy when relevant specimens are submitted. 

Endometrium Raloxifene has not been associated with endometrial proliferation. Investigate unexplained uterine bleeding as clinically indicated. 

Norethindrone Secondary amenorrhea abnormal uterine bleeding endometriosis. Megestrol ... 

Secondary amenorrhea/abnormal uterine bleeding - For secondary amenorrhea and for abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology, such as fibroids or uterine cancer. 

Progesterone Hormone produced naturally by corpus luteum, adrenals and placenta. Serum half-life is only a few minutes Dysfunctional uterine bleeding. Sustaining pregnancy in threatening abortion... 

Norethisterone Synthetic progestogen Abnormal uterine bleeding. Endometriosis, component of some oral contraceptives and in hormone replacement therapy... 

High-dose monophasic preparations are indicated for the management of dysfunctional uterine bleedings and when persistent breakthrough bleedings occur with low-dose oral contraceptives. The monophasic combinations are taken in a fixed dose combination once daily over 21 or 22 days, followed by an interval of 7 or 6 days. 

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