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Metrorrhagia Management

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Metrorrhagia Management, Anovulatory Bleeding Management

  • See Also
  1. Anovulatory Bleeding (Metrorrhagia)
  2. Abnormal Uterine Bleeding
  3. Menorrhagia Management (Ovulatory Bleeding Management)
  4. Menstrual Cycle
  5. Abnormal Uterine Bleeding Causes
  6. Ovulatory Bleeding (Menorrhagia)
  7. Uterine Bleeding in Pregnancy
  8. First Trimester Bleeding
  9. Late Pregnancy Bleeding
  10. Endometrial Cancer Screening
  11. Oral Contraceptive-Related Uterine Bleeding Management
  12. Postmenopausal Bleeding
  13. Amenorrhea
  14. Lower GI Bleed
  15. Hematuria
  • Indication
  1. Anovulatory Bleeding (Metrorrhagia)
  1. Prevent Endometrial Hyperplasia
  2. Prevent Uncoordinated Sloughing
  • Management
  1. Oral Contraceptive
    1. Switch to Levonorgestrel containing pill
    2. Avoid when Oral Contraceptive is contraindicated (e.g. Tobacco users over age 35 years)
    3. Limit Ethinyl Estradiol to no more than 35 mcg
      1. Lower Estrogen is not associated with bleeding
  2. Medroxyprogesterone acetate (Provera)
    1. Provera 10 mg oral daily for 10-14 days per month
  3. Norethindrone (Aygestin)
    1. Dose: 5 mg PO tid cycle days 15 to 25
  4. Micronized Progesterone (Prometrium)
    1. Dose: 200 mg PO qd for cycle days 12 to 25
  5. Levonorgetrel-Releasing IUD (Mirena)
    1. IUD containing 52 mg Levonorgestrel
  • References
  1. Nelson (1997), Fam Prac Recert 19(8):14
  2. Apgar (2000) Am Fam Physician 62:1839-50 [PubMed]
  3. Buchanan (2009) Am Fam Physician 80(10): 1075-88 [PubMed]
  4. Sweet (2012) Am Fam Physician 85(1): 35-43 [PubMed]