Endometrial vascular changes and bleeding disturbances with long-acting progestins

I Fraserab, I S Fraser, M Hickey
Steroids · 2000 · vol. 65(10-11) , pp. 665–670 · doi:10.1016/s0039-128x(00)00188-4 · PMID:11108874 · W2047492065
Review OA: closed CC0 ⤵ 9 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This paper investigates alterations in endometrial blood vessels and associated bleeding irregularities in individuals using long-acting progestins.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

Unscheduled disturbances of bleeding with long-acting progestogen-only methods continue to be a major social inconvenience, and the most common reason for premature discontinuation of use. The patterns of bleeding with different methods are now well characterised, but in spite of a substantial amount of recent research we still do not clearly understand the actual mechanisms underlying these disturbances. The major changes occur locally within the endometrium, although these are influenced substantially by different dosages and regimens of contraceptive steroids. Hysteroscopic studies have demonstrated major changes in the extent of superficial endometrial vascularization, disturbances in superficial vascular morphology, and increased endometrial vascular and epithelial fragility in progestogen-only users. There may also be alterations in endometrial perfusion and vasomotion. Laboratory studies of cellular and molecular mechanisms have shown changes in vascular basement membranes, pericytes, migratory leukocytes, cellular architecture, cell adhesion molecules, and intercellular matrix breakdown systems, such as matrix metalloproteinases. It appears that continuous exposure to progestogen, in the presence of low to moderate levels of estrogen, results in an endometrium that histologically demonstrates 'suppressed secretory' changes, associated with disturbed angiogenesis, and a tendency to release molecules capable of causing focal endometrial epithelial and endothelial damage and bleeding.

My notes (saved in your browser only)

MeSH descriptors

Blood Vessels Endometrium Hemorrhage Progestins Blood Vessels Blood Vessels Delayed-Action Preparations Endometrium Endometrium Endometrium Endothelium, Vascular Endothelium, Vascular Endothelium, Vascular Female Hemorrhage Hemorrhage Hemorrhage Humans Progestins

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (28)

Cited by (7)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-10-08T20:59:38.477535+00:00
License: CC0 · commercial use OK