Estrogen therapy for dysfunctional uterine bleeding

Examples

Generic Name Brand Name
conjugated estrogens Premarin
esterified estrogens Menest
estradiol Delestrogen, Estrace
estropipate Ogen

Some estrogens used to treat dysfunctional uterine bleeding are taken as pills. And some can be given through a vein (intravenous).

How It Works

High levels of estrogen trigger the rapid growth of the uterine lining (endometrium). This stops sudden, heavy bleeding from the uterine surface.

Why It Is Used

High-dose estrogen is used to reduce sudden, heavy uterine bleeding. Usually, 24 hours of intravenous (IV) or oral (pills or tablets) estrogen therapy is followed with 7 to 10 days of oral estrogen plus progestin.1

During perimenopause, when the body makes less estrogen, some women take estrogen along with progestin to regulate the menstrual cycle and reduce dysfunctional uterine bleeding. For more information, see birth control pills, patch, or ring.

How Well It Works

Estrogen therapy effectively controls sudden, heavy uterine bleeding that is not caused by disease, pregnancy complication, cancer, or another serious medical condition (dysfunctional uterine bleeding).1

Recurrence. Dysfunctional uterine bleeding may return when treatment with estrogen and progestin is stopped.

Side Effects

Frequent side effects caused by estrogen can include:

  • Headaches.
  • Nausea.
  • Vaginal discharge.
  • Fluid retention.
  • Swollen breasts.
  • Weight gain.
  • Spotting or darkening of the skin, particularly on the face.

Rare side effects include:

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Short-term estrogen therapy is followed by 7 to 10 days of estrogen-plus-progestin treatment to stimulate healthy growth of the endometrium. When treatment stops, withdrawal bleeding, much like menstrual bleeding, can occur.

Estrogen therapy is generally not recommended if you have:

  • Uncontrolled high blood pressure.
  • Liver disease.
  • History of blood clots in a vein (deep vein thrombosis) or lung (pulmonary embolism).
  • History of stroke.
  • History of breast or uterine cancer.

If you have very heavy bleeding, the benefits of short-term estrogen therapy may outweigh the possible risks.

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References

Citations

  1. Lobo RA (2007). Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In VL Katz et al., eds., Comprehensive Gynecology, 5th ed., pp. 915–931. Philadelphia: Mosby Elsevier.

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