Abnormal uterine bleeding associated with hormonal contraception.

Area of Science:

• Reproductive Health
• Contraception Management
• Gynecology

Background:

• Hormonal contraception, including OCPs, injections, and implants, is widely used by millions of women.
• Abnormal uterine bleeding (AUB) is a frequent side effect of hormonal contraception.
• AUB is a primary reason for discontinuing hormonal contraception, increasing the risk of unplanned pregnancy.

Purpose of the Study:

• To outline the evaluation and management strategies for abnormal uterine bleeding in women using hormonal contraception.
• To provide guidance on addressing a common side effect that impacts contraceptive adherence.

Main Methods:

• Evaluation involves assessing patient compliance with hormonal contraception.
• A thorough medical history and physical examination are crucial to rule out organic causes of bleeding.
• Targeted laboratory tests are employed to identify potential underlying issues.

Main Results:

• Pregnancy and incorrect oral contraceptive pill (OCP) use are identified as frequent causes of AUB.
• Initial AUB during the first three months of OCP use often requires counseling and reassurance.
• Persistent AUB beyond three months may necessitate treatment with supplemental estrogen, NSAIDs, or changes in OCP formulation.

Conclusions:

• Management of AUB in women using progestin-only methods involves counseling and reassurance.
• Supplemental estrogen or NSAIDs can be administered during bleeding episodes for progestin-only contraceptive users.
• Adjusting OCPs to higher estrogen content or different progestin formulations are viable options for persistent AUB.