How to stop bleeding using endometrial atrophy

Endometrial atrophy is also a method of using hormones to stop bleeding. The principle of this method is that large doses of synthetic progesterone or estrogen and progesterone preparations inhibit the secretion of gonadotropin by the pituitary gland and then inhibit the secretion of estrogen by the ovaries. The reduction of endogenous estrogen causes the endometrium to shrink, resulting in a rapid reduction or cessation of bleeding. It includes two preparations:

①Synthetic progesterone preparations; Commonly used drugs for synthetic progesterone preparations include: norethindrone (Fukang Tablets) 2.5~5.0mg/d, megestrol acetate 4~8mg/d or medroxyprogesterone 10~30mg/d. Generally, bleeding stops or significantly decreases 1~3 days after medication. After bleeding stops, the dosage can be gradually reduced and maintained for about 21 days. During this period, anemia should be actively corrected. After hemoglobin returns to normal, the drug can be stopped to allow withdrawal bleeding to occur.

② Estrogen and progesterone preparations: oral contraceptives. Any available oral contraceptive preparations can be used. 2 to 3 tablets per day. Usually, the bleeding stops or decreases significantly 1 to 3 days after taking the medicine. After the bleeding stops for 1 week, gradually reduce the dosage to 1 tablet per day and maintain it until the anemia is corrected before stopping the medicine.

Tpis:

The following aspects should be noted when using the endometrial atrophy method:

(1) It is used for patients with heavy bleeding and severe anemia, with hemoglobin lower than 90g/L, who are in urgent need of rapid hemostasis but do not need or are not suitable for curettage. It is suitable for hemostasis in female patients of any age with anovulatory functional uterine bleeding.

(2) Use with caution in patients with long-term smoking or severe hypertension.

(3) If breakthrough bleeding occurs when using synthetic progestin preparations, a small dose of estrogen can be used in combination.