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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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