Dysfunctional uterine bleeding medical therapy

Dysfunctional uterine bleeding Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Treatment

Management of dysfunctional uterine bleeding predominantly consists of reassurance, though mid-cycle estrogen and late-cycle progestin can be used for mid- and late-cycle bleeding respectively. Also, non-specific hormonal therapy such as combined estrogen and progestin can be given.

The goal of therapy should be to arrest bleeding, replace lost iron to avoid anemia, and prevent future bleeding.

In general;

• IV estrogen, blood transfusion, IV fluids, curettage, hysterectomy or ligation of uterine artery are used to treat acute life-threatening bleeds.
• Treatment of underlying etiologies.

Pharmacotherapy

Acute Pharmacotherapies

• Oral contraceptives are used to treat nonacute bleeding.

  • Cyclic progesterone
  • Estrogen/progesterone
  • Other:

    • Fibrinolytic agents
    • Danazol
    • Tranexamic acid
    • Megestrol
    • GnRH analogs (Gonadotropin-releasing hormone)
    • Intrauterine progesterone

Contraindicated medications

Uterine bleeding is considered an absolute contraindication to the use of the following medications:

• Norelgestromin and Ethinyl Estradiol