A functional model for progestogen-induced breakthrough bleeding

Martha Hickey, Ian S. Fraser
In: Human Reproduction · 2000 · vol. 15(suppl 3) , pp. 1–6 · doi:10.1093/humrep/15.suppl_3.1 · PMID:11041215 · W2119662493
review OA: bronze CC0 ⤵ 15 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper presents a unified model for progestogen-induced breakthrough bleeding, proposing that superficial endometrial vascular fragility is the underlying mechanism supported by molecular and hysteroscopic observations.

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Abstract

During the past 5 years, a number of important advances have been made in our understanding of the mechanisms of sex steroid-induced breakthrough bleeding (BTB). These observations suggest that superficial endometrial vascular fragility may be the mechanism underlying BTB, and molecular changes in the microvasculature as well as hysteroscopic observations have supported this hypothesis. This paper aims to present a unified picture of our current understanding of BTB, particularly that associated with progestogens, to indicate current gaps in our knowledge and possible directions for future research.

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