Endometrial bleeding

ESHRE Capri Workshop Group, The ESHRE Capri Workshop Group, J Collins, P G Crosignani
Human reproduction update · 2007 · vol. 13(5) , pp. 421–431 · doi:10.1093/humupd/dmm001 · PMID:17337477 · W4245625910
review OA: bronze CC0 ⤵ 13 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper reviews the causes, diagnostic approaches, and management strategies for abnormal uterine bleeding across different age groups, emphasizing medical treatment as the initial choice.

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Abstract

Abnormal bleeding is a significant health problem, especially during adolescence and before menopause when anovulatory cycles are common. Curettage is rarely necessary to investigate or treat menstrual problems in adolescents, and its use should also be minimized in women younger than 40 years. In every age group, medical treatment is the initial choice, but surgical treatment by endometrial destruction or hysterectomy is sometimes required. Benign causes of bleeding include fibroids and possibly adenomyosis, but the indications for treatment in each case depend upon the extent of bleeding, not the extent of the lesion. Breakthrough bleeding (BTB) with combined oral contraceptives commonly leads to discontinuation of the method. As BTB tends to improve with time, in the first 3 months of pill use, unless there are obvious underlying causes, women should be reassured that it will likely settle. BTB is often the reason for discontinuing progestogen-only contraception, and there is a need for effective means of treating unscheduled bleeding. Bleeding occurs in approximately 3% of post-menopausal women, and the use of hormones increases the likelihood of bleeding by >5-fold. Knowledge of the underlying mechanisms of bleeding is essential to the development of effective treatment.

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Condition tags

adenomyosis

MeSH descriptors

Endometrium Menorrhagia Menorrhagia Menstrual Cycle Adolescent Adult Contraceptive Agents, Female Contraceptive Agents, Female Endometrium Female Humans Menorrhagia Menstrual Cycle Postmenopause Progesterone Progesterone Uterine Diseases Uterine Diseases

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (98)

Cited by (13)

Source provenance

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License: CC0 · commercial use OK