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de Medeiros SF, Yamamoto MM, Barbosa JS. Abnormal bleeding during menopause hormone therapy: insights for clinical management. Clin Med Insights Womens Health. 2013;6:13-24doi: 10.4137/CMWH.S10483.
de Medeiros, S. F., Yamamoto, M. M., & Barbosa, J. S. (2013). Abnormal bleeding during menopause hormone therapy: insights for clinical management. Clinical medicine insights. Women's health, 613-24. https://doi.org/10.4137/CMWH.S10483
de Medeiros, Sebastião Freitas, et al. "Abnormal bleeding during menopause hormone therapy: insights for clinical management." Clinical medicine insights. Women's health vol. 6 (2013): 13-24. doi: https://doi.org/10.4137/CMWH.S10483
de Medeiros SF, Yamamoto MM, Barbosa JS. Abnormal bleeding during menopause hormone therapy: insights for clinical management. Clin Med Insights Womens Health. 2013 Jan 23;6:13-24. doi: 10.4137/CMWH.S10483. eCollection 2013. PMID: 24665210; PMCID: PMC3941181.
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Clin Med Insights Womens Health. 2013 Jan 23;6:13-24. doi: 10.4137/CMWH.S10483. eCollection 2013.

Abnormal bleeding during menopause hormone therapy: insights for clinical management.

Clinical medicine insights. Women's health

Sebastião Freitas de Medeiros, Márcia Marly Winck Yamamoto, Jacklyne Silva Barbosa

Affiliations

  1. Department of Gynecology and Obstetrics, Medical Science School, Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil. ; Tropical Institute of Medicine Reproductive and Menopause, Cuiabá, Mato Grosso, Brazil.
  2. Tropical Institute of Medicine Reproductive and Menopause, Cuiabá, Mato Grosso, Brazil.

PMID: 24665210 PMCID: PMC3941181 DOI: 10.4137/CMWH.S10483

Abstract

OBJECTIVE: Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy.

METHODS: A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding.

RESULTS: Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women at higher risk for bleeding, and adapt the regimen to suit eachwoman's characteristics. Abnormal bleeding with progesterone/progestogen only, combined sequential, or combined continuous regimens may be corrected by changing the progestogen, adjusting the progestogen or estrogen/progestogen doses, or even switching the initial regimen to other formulation.

CONCLUSION: To diminish the occurrence of abnormal bleeding during hormone therapy (HT), it is important to tailor the regimen to the needs of individual women and identify those with higher risk of bleeding. The use of new agents as adjuvant therapies for decreasing abnormal bleeding in women on HT awaits future studies.

Keywords: abnormal uterine bleeding; climacteric; endometrium; hormone therapy; menopause

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