Progestin for dysfunctional uterine bleeding

Examples

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Progestins, synthetic versions of the hormone progesterone, are used at two dose levels to treat dysfunctional uterine bleeding:

• Birth control pills.
• High-dose progestin.

Oral (pill)

Brand Name	Chemical Name
Provera	medroxyprogesterone

Brand Name	Chemical Name
Norlutin	norethindrone

Brand Name	Chemical Name
Norlutate	norethindrone acetate

Brand Name	Chemical Name
Prometrium	progesterone (micronized)

The levonorgestrel intrauterine device (IUD) is also a progestin treatment for dysfunctional uterine bleeding. This type of IUD continually releases levonorgestrel, a form of progesterone, into the uterus.

How It Works

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Progestins prevent overgrowth of the endometrium, which helps prevent dysfunctional uterine bleeding. (Heavy bleeding is often the product of irregular breakdown of an overgrown endometrium.) In teens and women who aren't ovulating regularly, progestins help restore a predictable monthly menstrual period.

Why It Is Used

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Progestins are used to treat irregular menstrual periods when no other uterine disease is present (dysfunctional uterine bleeding). They are mainly used to restore hormonal balance and normal menstrual bleeding in teens and women who aren't ovulating, but are helpful for some ovulating women with irregular menstrual bleeding.¹

Progestin pills used to treat uterine bleeding are not the same progestin pills used for birth control. A levonorgestrel intrauterine device (IUD) or a combination estrogen-progestin birth control pill is a better choice for women who want to prevent pregnancy.²

How Well It Works

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Progestin therapy effectiveness varies with the type of dysfunctional uterine bleeding treated and the dosage and timing of treatment.

Side Effects

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The side effects of high-dose progestins may include:²

• Breast tenderness.
• Nausea.
• Bloating.
• Mood changes or depression.
• Headache.
• Water retention.
• Weight gain.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Many health professionals consider short-term cycled progestin as a first-line treatment for dysfunctional uterine bleeding.

Oral progestin in the dose prescribed for dysfunctional uterine bleeding is not an effective birth control agent. Use a dependable form of birth control if you wish to prevent pregnancy.

Oral progestin is generally considered a reasonable treatment choice for women with dysfunctional uterine bleeding who can't use other treatments because of chronic illness.²

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Mishell DR Jr, et al. (2001). Abnormal uterine bleeding. In MA Stenchever et al., eds., Comprehensive Gynecology, 4th ed., pp. 1079–1097. St. Louis: Mosby.

2. Speroff L, Fritz MA (2005). Dysfunctional uterine bleeding. In L Speroff, MA Fritz, eds., Clinical Gynecologic Endocrinology and Infertility, 7th ed., pp. 548–571. Philadelphia: Lippincott Williams and Wilkins.

Credits

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Author	Merrill Hayden
Editor	Kathleen M. Ariss, MS
Associate Editor	Michele Cronen
Associate Editor	Pat Truman
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
Last Updated	February 22, 2006