A functional model for progestogen-induced breakthrough bleeding

• Published in: Human reproduction (Oxford) Vol. 15; no. suppl-3; pp. 1 - 6
• Main Authors: Hickey, M., Fraser, I.S.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Oxford University Press 01.08.2000
• Subjects: Biological and medical sciences; breakthrough bleeding; Drug toxicity and drugs side effects treatment; endometrium; Endometrium - blood supply; Endometrium - drug effects; Epithelium - drug effects; Epithelium - pathology; Female; Humans; Medical sciences; Microcirculation - drug effects; Microcirculation - pathology; microvasculature; Models, Biological; Pharmacology. Drug treatments; Progestins - adverse effects; Progestins - pharmacology; progestogens; Toxicity: urogenital system; Uterine Hemorrhage - chemically induced; Uterine Hemorrhage - pathology; breakthrough bleeding; endometrium; progestogens; microvasculature; Human; Microcirculation; Menstruation disorders; Menstruation; Toxicity; Female; Contraceptive; Progesterone; Sex steroid hormone; Mechanism of action; Ovarian hormone; Progestagen
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/15.suppl_3.1

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.