Abnormal excessive per vagina (PV) bleeding on Esmya–selective progesterone receptor modulator (SPRM) in a symptomatic patient with uterine fibroid

Lyubov Matytsina-Quinlan; Laura Matytsina

doi:10.1136/bcr-2014-209015

Abnormal excessive per vagina (PV) bleeding on Esmya–selective progesterone receptor modulator (SPRM) in a symptomatic patient with uterine fibroid

Lyubov Matytsina-Quinlan, Laura Matytsina

BMJ case reports · 2015 · vol. 2015 , pp. bcr2014209015 · doi:10.1136/bcr-2014-209015 · PMID:25976198 · PMC4434339 · W1827360180

article OA: bronze CC0

📄 Open PDF View on OpenAlex View on PubMed View at publisher

Abstract

A woman in her late 40s presented with excessive per vagina (PV) bleeding and uterine fibroid. She reported excessive PV bleeding after starting Esmya; she was brought in by ambulance to the emergency department with profuse bleeding. Abnormal uterine bleeding (AUB) developed after selective progesterone receptor modulator (SPRM) administration in this symptomatic patient with uterine fibroid. The drug was withheld and surgical treatment considered. Progressive deterioration of PV bleeding after receiving SPRM led to an urgent laparoscopic total hysterectomy, which had to be postponed due to severe anaemia. Surgery took place regardless because the excessive bleeding continued. Histology revealed a 6 cm submucosal uterine fibroid (SMUF) and adenomyosis. Physicians prescribing SPRMs to stop PV bleeding should be aware of potential AUB, which could lead to urgent hysterectomy. The mechanism of action of SPRMs is not clearly understood. Awareness of the side effects of Esmya, such as AUB, must be kept in mind when administering SPRMs.

My notes (saved in your browser only)

Condition tags

adenomyosis

MeSH descriptors

Anemia Contraceptive Agents Hysterectomy Laparoscopy Leiomyoma Norpregnadienes Uterine Hemorrhage Anemia Contraceptive Agents Contraindications Female Humans Leiomyoma Middle Aged Norpregnadienes Severity of Illness Index Treatment Outcome Uterine Hemorrhage Uterine Hemorrhage

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cites (2)

References (11)

Histopathological correlation of adenomyosis and leiomyoma in hysterectomy specimens as the cause of abnormal uterine bleeding in women in different age groups in the Kumaon region: A retroprospective study via openalex
Progesterone receptor modulators in gynaecological practice via openalex
W2125998976 via openalex
W2171904793 via openalex
W2476322142 via openalex
W2478829584 via openalex
W2735227357 via openalex
W2977025277 via openalex
W1980216613 via openalex
W4285719527 via openalex
W2112743404 via openalex

Source provenance

europepmc: last seen: 2026-06-19T06:14:56.452680+00:00
openalex: last seen: 2026-06-04T00:00:01.174412+00:00
pubmed: last seen: 2026-05-13T22:17:52.213533+00:00

License: CC0 · commercial use OK

[1] Histopathological correlation of adenomyosis and leiomyoma in hysterectomy specimens as the cause of abnormal uterine bleeding in women in different age groups in the Kumaon region: A retroprospective study 2013

[2] Progesterone receptor modulators in gynaecological practice 2010