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Query: UMLS:C0547004 (Intermenstrual bleeding)
 32 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Concerns about abnormal menstrual bleeding are a common reason for women to consult a primary care physician. The first step in the evaluation is to determine the patient's ovulatory status. Women with heavy bleeding but normal ovulatory cycles should be evaluated for coagulopathies, structural lesions, and hypothyroidism. In the absence of a systemic or structural cause, menorrhagia can be treated with OCPs or NSAIDs. Intermenstrual bleeding in OCP users may be due to noncompliance or the use of low-dose pills. Encouraging patient compliance and adjustment of the estrogen dose can often solve the problem. If the patient is not on OCPs, intermenstrual bleeding is usually due to a structural or inflammatory lesion. The differential diagnosis for anovulatory bleeding is extensive. Pregnancy, systemic illnesses, and structural lesions should be ruled out by history, physical examination, and laboratory evaluation. Endometrial biopsy is indicated in patients over age 35 and younger patients with risk factors for endometrial cancer, such as chronic anovulation and obesity. Dysfunctional uterine bleeding is a nonspecific term for abnormal uterine bleeding in the absence of systemic or structural disease. It is usually associated with anovulation. Adolescents frequently have dysfunctional uterine bleeding owing to immaturity of the hypothalamic-pituitary-ovarian axis. Perimenopausal women have an increased incidence of irregular bleeding secondary to decreased estrogen production by the ovary. Obesity, polycystic ovary syndrome, stress, crash diets, and vigorous exercise can all disrupt normal ovulatory function. Treatment options for dysfunctional uterine bleeding include oral contraceptives, cyclic progesterone, or hormone replacement with estrogen and progesterone. Patients with structural lesions or those who do not resume normal withdrawal bleeding patterns on hormone therapy should be referred to a gynecologist for further evaluation and treatment.
Med Clin North Am 1995 Mar
PMID:Abnormal uterine bleeding. 787 94

Manufacturers have steadily been decreasing the amounts of estrogen and progestin in oral contraceptives (OCs) in an effort to enhance safety and tolerability while preserving contraceptive efficacy. A new formulation containing 20 microg ethinyl estradiol (EE) and 100 microg levonorgestrel (LNG)--representing the lowest available contraceptive dose of each hormone--has undergone extensive clinical testing in the United States and Germany. A total of 1590 women in 61 centers received 20 microg EE and 100 microg LNG for 6 cycles. Overall, 4 pregnancies possibly related to treatment failure were reported, reflecting an overall Pearl Index (number of pregnancies per 100 woman-years of treatment) of 0.65 and a failure rate of 0.34%. Cycle control was typical of low-dose OC use. Spotting and breakthrough bleeding occurred most commonly during the earlier cycles in each study. Adverse events were typical of those seen with OC use and led to study discontinuation in 6.6% of the women. Intermenstrual bleeding was the cause for early study withdrawal in 2.6% of women. The study results suggest that the combination of 20 microg EE and 100 microg LNG offers the benefits of low hormone content with good contraceptive efficacy, cycle control, and tolerability.
Clin Ther 1999 Jan
PMID:International clinical experience with a new low-dose, monophasic oral contraceptive containing levonorgestrel 100 microg and ethinyl estradiol 20 microg. 1009 Apr 29

Between the fall of 1991 and the fall of 1992, 1500 physicians from throughout France followed 5989 women, 13-56 years old, using the combined oral contraceptive (OC) Moneva (30 mcg ethinyl estradiol and 75 mcg of the new generation progestogen, gestodene) for 3-6 months for a total of 29,000 cycles. Moneva was prescribed in 60% of the cases because the women did not tolerate a previous OC. Moneva effectively prevented pregnancy. It reduced the rate of abnormal cycles (5.4% of cycles vs. 0.9% at 3 months and 0.6% at 6 months). Intermenstrual bleeding also decreased in frequency from 13.8% to 6.1% at 6 months. Amenorrhea occurred less often with Moneva (2.8% vs. 1.1% at 3 and 6 months). Moneva also reduced the length of the menstrual period (20.7% of women with long period vs. 3.3% at 6 months) and excessive menstruation (1.4% vs. 0.2% at 6 months). Pain during menstruation, breast tenderness, and secondary effects occurred less frequently as well (37.1% vs. 13.5% at 3 months and 9/7% at 6 months, 13% vs. 7.9% at 6 months, and 15.1% vs. 11.1% at 3 months and 9% at 6 months, respectively). Secondary effects included headaches, nausea, and heavy legs. Moneva did not affect body weight or arterial blood pressure. 95% of women who took Moneva for 6 months were satisfied with it. 83.8% said that they would continue to use it. In conclusion, Moneva is an effective, safe, tolerable, and acceptable OC for women of all ages.
C R Ther Pharmacol Clin 1993
PMID:[Oral contraception with Moneva: findings of a cohort study of 6000 women]. 1231 72