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Combination Therapy Am Fam Physician. Acute uterine bleeding is a common clinical presentation in nonpregnant women of reproductive age, and its optimal treatment is unclear. Surgical options include dilation and curettage, uterine artery embolization, and hysterectomy.

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Medical therapies include estrogen therapy, progestin therapy, or combination daily contraceptives. Few scientific data exist on the effectiveness, comprar viagra argentina effects, or patient satisfaction associated with these approaches.

Munro and colleagues compared the two most popular medical treatments i. The study included women presenting to an emergency medroxyprogesterone, gynecology urgent care center, or outpatient clinic of a medroxyprogesterone health plan because of acute uterine bleeding.

Study participants were at least 18 years of age, not pregnant, medroxyprogesterone 20mg daily, premenopausal, and hemodynamically stable with 20mg hemoglobin concentration 20mg at least 8 g per dL 80 g per L. Patients with structural defects that could account for bleeding were excluded by physical examination, augmented by transvaginal ultrasonography if appropriate.

Other exclusion daily included use of an intrauterine device, recent uterine surgery or infertility treatment, and any contraindication to the study medications.

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Patients were screened by a medroxyprogesterone addressing daily, medical, and gynecologic data. Medroxyprogesterone also received physical and gynecologic examinations and hemoglobin concentration and pregnancy 20mg. Other tests were performed at the discretion of the patients' physicians. Participants were randomly allocated to treatment with daily medroxyprogesterone acetate Provera; 20mg mg three times daily for seven days or a combination oral contraceptive three times daily for seven days, medroxyprogesterone 20mg daily.

After the initial seven days, medroxyprogesterone 20mg daily, treatment continued with 20 mg daily of medroxyprogesterone acetate or one combination oral contraceptive tablet daily for three weeks. Patients recorded daily use of the medications, pad and tampon counts, symptoms e. Patients were reassessed after two and four weeks. The 20 women in each group did not differ significantly in any important variable, although the mean duration of bleeding before randomization was The average age of participants was daily 43 years, the mean body mass index was about 30 kg per m2, and the mean hemoglobin concentration was At four weeks, complete data were available for 17 women 85 percent in the progestin group and for 16 women 80 percent in the combination group.

In both groups, the median time to cessation of bleeding was three days. At medroxyprogesterone two-week visit, 76 percent of women treated with the progestin and 88 20mg treated with the combination oral contraceptive reported cessation of bleeding.

The only surgery performed was dilation and curettage in one patient in the combination group.

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The groups did not differ in symptom scores for nausea, cramping, or bloating or in daily patient satisfaction scores. Although this small study had some difficulties with compliance and follow-up, the authors conclude that 20mg regimens provided effective and acceptable therapy for acute uterine bleeding in stable, nonpregnant patients. medroxyprogesterone

The incidence and severity of adverse effects were low, and surgical interventions were avoided. The authors 20mg for larger randomized studies to confirm their results. Read the full article. Get daily access, anytime, anywhere. Choose a single article, issue, or medroxyprogesterone subscription.

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