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Menopause (New York, N.Y.) Apr 2011Pharmacological therapies for the treatment of abnormal uterine bleeding are effective and generally well tolerated. This review presents an evidence-based approach to... (Review)
Review
Pharmacological therapies for the treatment of abnormal uterine bleeding are effective and generally well tolerated. This review presents an evidence-based approach to medical therapy. Selection depends on the etiology and amount of bleeding, need for contraception or preservation of fertility, perimenopause status, and medication efficacy and adverse effects.Available nonhormonal agents include nonsteroidal anti-inflammatory agents, which reduce bleeding by 25% to 35% and improve dysmenorrhea through reduced prostaglandin levels; tranexamic acid, which inhibits plasminogen activator with a 40% to 60% reduction in menstrual blood loss; and intranasal desmopressin, which is an antifibrinolytic for women with an underlying bleeding disorder (eg, von Willebrand disease).Hormonal regimens cause the inhibition of endometrial growth. Cyclic progestogen therapy for 21 days results in a significant reduction in menstrual blood loss. Limited data suggest that oral contraceptives reduce menstrual blood loss by 40% to 50% with decreased breast tenderness and dysmenorrhea and a reduction in risk of uterine and ovarian cancer. The progestin-releasing intrauterine devices are effective up to 97% by 6 months and provide relief of dysmenorrhea and contraception. Long-acting progestogen injections produce amenorrhea and provide contraception but are associated with irregular spotting and reversible bone loss. Danazol leads to endometrial atrophy with a reduced menstrual loss; androgenic adverse effects may be lessened with lower doses or vaginal use. Gonadotrophin agonists lead to ovarian suppression and are used to shrink fibroids or the endometrium preoperatively but are limited by hypoestrogenic adverse events. Emergency use of parenteral conjugated estrogens has a 70% chance of stopping abnormal bleeding but an increased risk of thrombosis.
Topics: Female; Humans; Metrorrhagia
PubMed: 21701432
DOI: 10.1097/gme.0b013e318212499c -
Journal of Midwifery & Women's Health 2012Abnormal uterine bleeding is one of the most common reasons that reproductive-aged women seek health care. The causes are varied, depending in large part on the age and... (Review)
Review
Abnormal uterine bleeding is one of the most common reasons that reproductive-aged women seek health care. The causes are varied, depending in large part on the age and life stage of the woman. Thus, diagnosis requires a systematic approach that is driven by a thorough health history and review of presenting symptoms. In recent years, the treatment of abnormal uterine bleeding has moved away from surgical procedures in favor of more conservative, yet effective, hormonal therapy such as combined contraceptives and the levonorgestrel-releasing intrauterine system. Clinicians must be knowledgeable about the various abnormal uterine bleeding treatment options and partner with women to develop appropriate, individualized treatment plans. The purpose of this article is to synthesize the current literature to describe the contributing etiologies, common presentations, diagnosis, evaluation, and management of abnormal uterine bleeding.
Topics: Contraceptive Agents, Female; Female; Humans; Hysterectomy; Hysteroscopy; Intrauterine Devices, Medicated; Menorrhagia; Metrorrhagia; Treatment Outcome
PubMed: 22594864
DOI: 10.1111/j.1542-2011.2012.00178.x -
El Dia Medico Jun 1954
Topics: Abortion, Induced; Abortion, Spontaneous; Female; Humans; Menorrhagia; Metrorrhagia; Pregnancy; Uterine Perforation
PubMed: 13191195
DOI: No ID Found -
Boletin. Sociedad Chilena de... 1955
Topics: Climacteric; Female; Humans; Menopause; Menorrhagia; Metrorrhagia; Postmenopause
PubMed: 13342112
DOI: No ID Found -
Archives de Pediatrie : Organe Officiel... Jun 2008
Topics: Adolescent; Female; Humans; Menorrhagia; Metrorrhagia; Puberty
PubMed: 18582680
DOI: 10.1016/S0929-693X(08)71841-4 -
Ugeskrift For Laeger Feb 1997A consensus conference on menstrual disorders concluded that a discrepancy exists between the large number of curettages performed annually on fertile women and the... (Review)
Review
A consensus conference on menstrual disorders concluded that a discrepancy exists between the large number of curettages performed annually on fertile women and the actual findings of cancer of the endometrium in this group of patients. Based on three written simulated consultations (vignettes) with 42-year-old women with metrorrhagia but without increased risk of cancer a decision analysis was performed among 695 general practitioners in Denmark and the Faroe Islands. The first choice of treatment was curettage in 43% of the responders. It was found that a large proportion of doctors decided on curettage when the patient had developed anaemia. The choice of curettage was associated with the doctors' assessment of need to exclude cancer of the endometrium, while doctors who gave high priority to non-invasive treatment and cessation of bleeding were less likely to refer for curettage. A larger proportion of male than female doctors chose curettage as primary treatment.
Topics: Adult; Decision Making; Dilatation and Curettage; Female; Humans; Metrorrhagia
PubMed: 9045467
DOI: No ID Found -
Srpski Arhiv Za Celokupno Lekarstvo Mar 1966
Topics: Female; Humans; Hysterosalpingography; Metrorrhagia
PubMed: 5960581
DOI: No ID Found -
El Dia Medico Aug 1957
Topics: Female; Humans; Menorrhagia; Metrorrhagia
PubMed: 13473557
DOI: No ID Found -
Gazette Medicale de France Jul 1955
Topics: Female; Humans; Menorrhagia; Metrorrhagia
PubMed: 13241715
DOI: No ID Found -
Medicina Dec 1954
Topics: Female; Humans; Menorrhagia; Metrorrhagia
PubMed: 13235034
DOI: No ID Found