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Mechanisms Underlying Menstrual Bleeding Disturbances with Progestogens

  • Conference paper
New Mechanisms for Tissue-Selective Estrogen-Free Contraception

Part of the book series: Ernst Schering Research Foundation Workshop ((SCHERING FOUND,volume 52))

9.13 Conclusion

Progestogen contraceptives are almost inevitably associated with disruptions in menstrual bleeding patterns. In many cases this amounts to bleeding that is frequent and/or prolonged. Evidence from studies of all available preparations suggests that menstrual disturbance is one of the most common reasons for discontinuation of these methods. This is particularly unfortunate since many progestogen users are women who have been unable to find other suitable methods and may now have very limited choices of safe contraception available to them.

Currently, there is no effective long-term management for bleeding disturbances and effective and acceptable treatments are unlikely to be developed without a fuller understanding of the factors underlying this bleeding. Recent information has greatly advanced understanding of the vascular and endometrial changes associated with progestogen use, but a number of areas require further study before the mechanisms of BTB can be defined. In addition, further information is required from women using these preparations in developing and developed countries regarding the perception of bleeding disturbances and the relative tolerability of varying bleeding patterns and of amenorrhea.

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Authors and Affiliations

  1. School of Women’s and Infants’ Health, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Rd, Subiaco, WA, 6008, Australia

    M. Hickey

  2. Department of Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland

    C. d’Arcangues

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  1. Instituto Chileno de Medicina Reproductive (ICMER), José Ramon Gutierrez 295, Santiago de Chile, Chile

    H. B. Croxatto

  2. Strategic Business Unit, Gynecology and Andrology, Schering AG, Müllerstr. 178, 13342, Berlin, Germany

    R. Schürmann  & I. Schellschmidt  & 

  3. CRBA, Gynecology and Andrology, Female Health Care, Schering AG, Müllerstr. 178, 13342, Berlin, Germany

    U. Fuhrmann

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Hickey, M., d’Arcangues, C. (2005). Mechanisms Underlying Menstrual Bleeding Disturbances with Progestogens. In: Croxatto, H.B., Schürmann, R., Fuhrmann, U., Schellschmidt, I. (eds) New Mechanisms for Tissue-Selective Estrogen-Free Contraception. Ernst Schering Research Foundation Workshop, vol 52. Springer, Berlin, Heidelberg . https://doi.org/10.1007/3-540-27147-3_9

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