Targeted treatments for dysfunctional uterine bleeding based on endometrial thickness

Thi Thi Htwe, Hla Hla Yi, Saw Kler Ku
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2020 · vol. 9(3) , pp. 900 · doi:10.18203/2320-1770.ijrcog20200570 · W3006205117
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This prospective hospital-based study evaluated the effectiveness of targeted hormonal treatments for dysfunctional uterine bleeding stratified by endometrial thickness. Researchers recruited sixty patients in Myanmar and divided them into three groups based on their measured endometrial thickness, administering specific hormonal therapies to each cohort. The results indicated that treatment was effective in 86.6% of patients regarding bleeding days and 70% regarding bleeding scores after one month, with increased endometrial thickness correlating with higher BMI. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Background: Dysfunctional uterine bleeding is a common presentation to both general practitioner and gynaecologists which can have a significant effect on a woman’s quality of life. The aim of this study is to assess the effectiveness of treating dysfunctional uterine bleeding according to endometrial thickness.Methods: This study was a hospital based prospective study undertaken in gynecology outpatient clinic of Central Women’s Hospital, Mandalay, Myanmar for one-year period (2016). A total of 60 patients were recruited and divided into 3 groups based on endometrial thickness and offered targeted hormonal treatments. At the end of the one-month treatment, patients were asked to return for a follow-up visit and from their menstrual diaries, the number of bleeding days and bleeding scores were assessed and calculated.Results: Among sixty women with dysfunctional uterine bleeding, 55% of patients had endometrial thickness less than 6 mm, 25% had endometrial thickness 6-11 mm, with 20% of patients having endometrial thickness more than 11 mm. After one month of study period, treatment was found to be effective in 86.6% of the patients according to bleeding days and in 70% of the patients according to bleeding score.Conclusions: In women presenting with dysfunctional uterine bleeding, increased endometrial thickness was found to be associated with increased BMI. In the treatment of dysfunctional uterine bleeding, when the endometrial thickness of the patient was assessed and hormonal treatment was given according to the endometrial thickness, treatment was proven to be effective.
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Background

Dysfunctional uterine bleeding is a common presentation to both general practitioner and gynaecologists which can have a significant effect on a woman’s quality of life. The aim of this study is to assess the effectiveness of treating dysfunctional uterine bleeding according to endometrial thickness.

Methods

This study was a hospital based prospective study undertaken in gynecology outpatient clinic of Central Women’s Hospital, Mandalay, Myanmar for one-year period (2016). A total of 60 patients were recruited and divided into 3 groups based on endometrial thickness and offered targeted hormonal treatments. At the end of the one-month treatment, patients were asked to return for a follow-up visit and from their menstrual diaries, the number of bleeding days and bleeding scores were assessed and calculated.

Results

Among sixty women with dysfunctional uterine bleeding, 55% of patients had endometrial thickness less than 6 mm, 25% had endometrial thickness 6-11 mm, with 20% of patients having endometrial thickness more than 11 mm. After one month of study period, treatment was found to be effective in 86.6% of the patients according to bleeding days and in 70% of the patients according to bleeding score.

Conclusions

In women presenting with dysfunctional uterine bleeding, increased endometrial thickness was found to be associated with increased BMI. In the treatment of dysfunctional uterine bleeding, when the endometrial thickness of the patient was assessed and hormonal treatment was given according to the endometrial thickness, treatment was proven to be effective. Metrics

References

Oriel KA, Schrager S. Abnormal uterine bleeding. Am Fam Phys. 1999;60(5):1371-80. Nice.org.uk., Heavy menstrual bleeding: assessment and management, 2018. Available at: https://www.nice.org.uk/guidance/ng88/resources/heavy-menstrual-bleeding-assessment-and-management-pdf-1837701412549. Accessed on 1st February 2020. Muneyyirci-Delale, O, Gupta A, Abraham, C, Chandrareddy, A, Bowers CH, Cutler, JB. Management of dysfunctional uterine bleeding based on endometrial thickness. Inter J Women's Health. 2010;2:297-302. de Vries, LD, Dijkhuizen, FP, Mol, BW, Brötmann, HA, Moret E, Heintz AP. Comparison of transvaginal sonography, saline infusion sonography, and hysteroscopy in premenopausal women with abnormal uterine bleeding. J Clin Ultrasound. 2000;28(5):217-23. Pilli GS, Sethi B, Dhaded AV, Mathur PR. Dysfunctional uterine bleeding (study of 100 cases), 2002. Available at: http//www.Journal-obgyn-india. com / articles / may-June 2002/g paper 87. Accessed on 12th May 2008. Mattox JH. Abnormal uterine bleeding, in Obstetrics and Gynaecology, 9th Edn, Mosby-Year book, Inc. St Louis; 1991:85-93. Win-Sein. Evaluation of cases clinically diagnosed as dysfunctional uterine haemorrhage. The dissertation submitted for the master degree of medical science (Obstetrics and Gynaecology) to University of Medicine, Mandalay. 1980. Thin-Thin-Myat. Diagnostic accuracy of Transvaginal Sonography Versus Saline Infusion Sonohysterography in Abnormal Uterine Bleeding. The thesis submitted for the doctoral degree of medical science (Obstetrics and Gynaecology) to University of Medicine, Mandalay. 2013.

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