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Metrorrhagia ManagementAka: Anovulatory Bleeding Management

See Also
1. Anovulatory Bleeding
2. Abnormal Uterine Bleeding
Indication
1. Anovulatory Bleeding (Metrorrhagia)
Goal: Correct Unopposed Estrogen
1. Prevent Endometrial Hyperplasia
2. Prevent Uncoordinated Sloughing
Management
1. Oral Contraceptive
  1. Switch to Levonorgestrel containing pill
  2. Lower Estrogen is not associated with bleeding
2. Medroxyprogesterone acetate (Provera)
  1. Provera 10 mg PO qd for cycle days 15 to 25
  2. Provera 5 mg PO qd continuously
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. Mirena (IUD containing 52 mg Levonorgestrel)
References
1. Apgar (2000) Am Fam Physician 62:1839

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 3/22/2010. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.