How to use estrogen and progesterone sequential therapy to treat anovulatory functional uterine bleeding

As we have mentioned above, the effect of using sex hormones to stop bleeding is generally good, but if the drug is stopped suddenly, the withdrawal bleeding will cause more trouble for patients who have been bleeding for a long time, so the drug should be continued after the bleeding stops to control the cycle, so that the number of days after the bleeding stops is about 20 days. Sequential therapy of estrogen and progesterone is one of the commonly used methods to adjust the menstrual cycle.

Sequential estrogen-progesterone therapy is an artificial cycle. In order to simulate the endocrine changes of the ovaries during the natural menstrual cycle, estrogen and progesterone are used sequentially to cause corresponding changes in the endometrium, causing periodic shedding. It is suitable for adolescents with functional uterine bleeding or those of childbearing age with low endogenous estrogen levels. After confirming that there are no contraindications to hormone therapy, sequential estrogen-progesterone therapy can be used to relieve symptoms and maintain regular bleeding.

The commonly used drugs for this therapy are: 1 mg of diethylstilbestrol (1 mg of Nokunfu or 0.625 mg of pregnant mare's estrone), taken once a night from the 5th day of bleeding, for 20 consecutive days, until the 11th day of medication, and 10 mg of progesterone injection (or 8-10 mg of medroxyprogesterone) is added daily by intramuscular injection. Both drugs are used up at the same time. Bleeding will occur 3-7 days after stopping the medication. The medication is repeated on the 5th day of bleeding. It is generally used for 3 consecutive cycles. After 2-3 cycles of medication, the patient can ovulate spontaneously; 0.625 mg/d of pregnant mare's estrone, used for 21-28 days, or 1 mg/d of estradiol valerate, used for 21 days, and a progestogen is added for 10-14 days starting from the 12th to 15th day; preparations that meet the requirements of estrogen and progesterone cyclic sequential treatment, such as clidone, can also be used.