What is the dose of progesterone (a steroid hormone) to stop a prolonged menstrual period that has been ongoing for 6 weeks, characterized by menorrhagia (abnormally heavy or prolonged menstrual bleeding)?

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From the Research

For prolonged menstrual bleeding lasting 6 weeks, oral medroxyprogesterone acetate (Provera) 10 mg daily for 10 days is typically recommended to stop the bleeding. This recommendation is based on the most recent and highest quality study available, which compared the efficacy of medroxyprogesterone acetate and tranexamic acid for treating heavy menstrual bleeding of endometrial origin 1. After completing this course, withdrawal bleeding may occur when the medication is stopped, but this should be lighter and of shorter duration than the current bleeding. Alternatively, norethindrone acetate 5-10 mg daily for 10-14 days can be used. These progestins work by stabilizing the endometrial lining and promoting organized shedding.

  • Key points to consider:
    • The dose and duration of treatment may vary depending on the individual's response and medical history.
    • It's essential to follow up with a healthcare provider after treatment to address the underlying cause of the prolonged bleeding, which could include hormonal imbalances, structural abnormalities, or other medical conditions.
    • A complete evaluation is necessary to determine appropriate long-term management and prevent recurrence.
  • Potential side effects and interactions:
    • Medroxyprogesterone acetate and norethindrone acetate can have different glucocorticoid agonist properties, which may affect their efficacy and side effect profiles 2.
    • High-dose estradiol may potentiate prolactin production from submaximal progestin doses, which could impact treatment outcomes 3.
  • Importance of individualized treatment:
    • The treatment approach should be tailored to the individual's specific needs and medical history.
    • Regular monitoring and follow-up are crucial to ensure the treatment is effective and to address any potential side effects or complications.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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