Disease relevance of Metrorrhagia

• OBJECTIVE: The purpose of this prospective study was to investigate the association of breakthrough bleeding with circulating estradiol levels and obesity in postmenopausal women receiving hormone replacement therapy [1].
• Herein, an SLE patient with a positive lupus anticoagulant (LAC) test who abruptly developed metrorrhagia 4 yr after diagnosis is reported [2].
• CONCLUSION: Depot goserelin and danazol both provide adequate endometrial preparation before rollerball endometrial ablation for treatment of menorrhagia due to ovulatory dysfunctional uterine bleeding [3].
• There was also an indication based on small sample sizes that mefenamic acid reduced blood loss in women with anovulatory dysfunctional uterine bleeding, fibroids, intrauterine devices, and von Willebrand disease [4].
• Uterine artery blood flow parameters in women with dysfunctional uterine bleeding and uterine fibroids: the effects of tranexamic acid [5].

High impact information on Metrorrhagia

• Because of the effect of felbamate on the pharmacokinetics of gestodene and the report of intermenstrual bleeding, it is possible that the contraceptive efficacy of low-dose combination oral contraceptives may be adversely affected during felbamate treatment [6].
• The occurrence of apparently intermenstrual bleeding prompted an evaluation of estrogen levels [7].
• Spontaneous ovarian activity, as reflected by the urinary excretion of total estrogen and pregnanediol measured serially (thrice weekly) over a period of 3-4 months, was studied in nine young women (15-27 yr old) with a history of dysfunctional uterine bleeding of at least 2-yr duration [8].
• Cycle control in open-label trials in women receiving up to 36 cycles of ethinylestradiol/levonorgestrel 20 microg/100 microg was generally good, with the incidence of intermenstrual bleeding being highest during the first few cycles of use and decreasing thereafter [9].
• None of the cases of dysfunctional uterine bleeding showed presence of plasma cells in either the hematoxylin and eosin stained or syndecan-1 stained sections [10].

Chemical compound and disease context of Metrorrhagia

• Although it was not as effective as intrauterine administration of levonorgestrel, the high incidence of amenorrhoea and adverse events such as intermenstrual bleeding resulting from such treatment may be unacceptable to some patients [11].
• OBJECTIVE: To confirm the advantages of goserelin prior to endometrial ablation for the treatment of dysfunctional uterine bleeding [12].
• Administration of antagonists of progesterone provide an excellent model to study the mechanisms involved in spontaneous and induced abortion as well as providing information which may help devise strategies for treating breakthrough bleeding associated with hormonal contraception [13].
• Progestin-only contraceptives are associated with breakthrough bleeding in up to 50% of users [14].
• Irregular, breakthrough bleeding occurred in 14% of the conjugated equine estrogens/medroxyprogesterone acetate users and in 54% of the conjugated equine estrogens/placebo users [15].

Biological context of Metrorrhagia

• Endometrial blood flow measured by xenon 133 clearance in women with normal menstrual cycles and dysfunctional uterine bleeding [16].
• There was no evidence for a role for apoptosis in the mechanisms that underlie progestin-induced endometrial breakthrough bleeding [17].
• The data arising from these studies were used to fit approximate functions relating the amount of norgestimate and ethinyl estradiol to the rate of spotting and breakthrough bleeding, gastrointestinal disturbance, and pregnancies [18].
• Oxidative stress, vitamin E and progestin breakthrough bleeding [19].
• John's Wort is associated with increased metabolism of norethindrone and ethinyl estradiol, breakthrough bleeding, follicle growth and ovulation [20].

Anatomical context of Metrorrhagia

• Prostaglandin synthesis in the endometrium of women with ovular dysfunctional uterine bleeding [21].

Gene context of Metrorrhagia

• Influence of different hormonal regimens on endometrial microvascular density and VEGF expression in women suffering from breakthrough bleeding [22].
• There was no difference in PP14 concentrations between those women with and without intermenstrual bleeding [23].
• No relationship between cytokeratin expression and breakthrough bleeding pattern was found [24].
• Total estradiol and progesterone receptor levels (TRE2, TRP) were measured in endometria of women with adult dysfunctional uterine bleeding (n = 2) and compared to those of controls [25].
• CONCLUSIONS: Intravenous tPA may be administered relatively safely in women who are menstruating and should be used with caution in women with a history of dysfunctional uterine bleeding [26].

Analytical, diagnostic and therapeutic context of Metrorrhagia

• CONCLUSION(S): A majority of the patients who had dysfunctional uterine bleeding and who were scheduled for an endometrial ablation or a levonorgestrel-releasing IUD were inclined to take a risk of 50% likelihood of treatment failure to avoid a hysterectomy [27].
• Goserelin acetate (Zoladex) plus endometrial ablation for dysfunctional uterine bleeding: a large randomized, double-blind study [12].
• In continuation of our studies on stress situations in female reproductive life span, serum lipid peroxide levels in terms of malondialdehyde (nmol/ml) have been determined in females [(n = 40) (aged between 35-40 years)] to undergo total abdominal hysterectomy (due to dysfunctional uterine bleeding) [28].
• Indications for surgery included postmenopausal bleeding in 10 patients, previous dysplasia with inadequate Papanicolaou test follow-up in 4, recurrent high grade squamous intraepithelial lesion in 1, chronic pelvic pain in 5, acute pain in 2, dysfunctional uterine bleeding in 2 and thickened endometrial stripe in 1 patient on tamoxifen [29].

References