{"paper_id":"02c5a813-e493-4ee8-a5bc-9e8ee6270afd","body_text":"Abstract\nBackground\nThe main cause for discontinuation of depot medroxyprogesterone acetate (DMPA) use is irregular menstrual bleeding. The exact pathophysiological mechanisms of irregular bleeding have remained unclear. Transvaginal Doppler is a non-invasive method for studying changes in blood flow which may highlight the underlying pathology in those cases with irregular uterine bleeding. The aim of this study was to quantify the uterine and subendometrial microvasculature in DMPA users with irregular bleeding pattern in comparison to DMPA users with amenorrhea.\nStudy design\nThis is a case control study. Forty users of DMPA were divided into two groups: one group included 20 users with irregular uterine bleeding and the second group included 20 amenorrheic users. Pulsatility index (PI) and resistance index (RI) of uterine and subendometrial blood vessels were determined. Power Doppler Energy was used to quantify the signal percentage of the subendometrial area.\nResults\nThere is significant reduction of PI and RI in the uterine artery and subendometrial microvasculature in cases of irregular uterine bleeding.\nConclusion\nIrregular uterine bleeding with DMPA associated with increased perfusion of uterine and subendometrial blood vessels.\nSimilar content being viewed by others\nReferences\nWesthoff C (2003) Depot-medroxyprogesterone acetate injection (Depo-ProveraR): a highly effective contraceptive option with proven long term safety. Contraception 68:75–87\nClark MK, Sower M, Levy BT, Tenhundfeld P (2001) Magnitude and variability of sequential estradiol and progesterone concentration in women using depot medroxyprogesterone acetate for contraception. Fertil Steril 75:179–185\nSenthong AJ, Taneepanichskul S (2009) The effect of tranexamic acid for treatment irregular uterine bleeding secondary to DMPA use. 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Transvaginal Doppler sonography for evaluation of irregular uterine bleeding with DMPA. Arch Gynecol Obstet 283, 1325–1328 (2011). https://doi.org/10.1007/s00404-010-1569-z\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-010-1569-z","source_license":"CC0","license_restricted":false}