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Related Concept Videos

Menses Phase01:18

Menses Phase

The uterine cycle begins with the menstrual phase, which is considered day one of the cycle and typically lasts about five days. This phase is characterized by the degeneration and shedding of the stratum functionalis, the functional layer of the endometrium.
When fertilization does not occur, the corpus luteum deteriorates, causing a significant drop in the levels of estrogen and progesterone in the body. This hormonal decrease triggers the release of prostaglandins, which cause the uterine...
Disorders of the Female Reproductive System01:24

Disorders of the Female Reproductive System

The female reproductive system can be affected by several disorders, including Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), endometriosis, and various forms of cancer. PMS and PMDD are cyclical conditions that cause physical and emotional distress, with symptoms that include edema, mood swings, and food cravings. PMDD is a more severe form of PMS characterized by increased symptom severity that peaks during the luteal phase and tends to improve or resolve shortly after...
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
The Menstrual Cycle01:19

The Menstrual Cycle

The menstrual cycle is a recurrent sequence of changes in the uterine endometrium, specifically its functional layer, the stratum functionalis. This cycle prepares the uterus for potential pregnancy. This cycle typically spans 21–35 days, averaging 28 days, and aligns with the ovarian cycle, regulated by fluctuating levels of ovarian hormones, primarily estrogen and progesterone.
The menstrual phase occurs from days 1 to 5 and involves the shedding of the stratum functionalis, as a uterine...
Disorders of Hemostasis01:24

Disorders of Hemostasis

Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Ovarian Cycle01:27

Ovarian Cycle

The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle length...

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Related Experiment Videos

Iatrogenic unscheduled (breakthrough) endometrial bleeding.

M Hickey1, I S Fraser

  • 1Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia.

Reviews in Endocrine & Metabolic Disorders
|December 11, 2012
PubMed
Summary

Erratic vaginal bleeding is a major drawback of long-acting progestogen-only contraceptives, leading to early discontinuation. Understanding individual endometrial responses is key to managing this common side effect.

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Area of Science:

  • Reproductive Health
  • Gynecology
  • Pharmacology

Background:

  • Long-acting progestogen-only contraceptives are widely used but associated with erratic vaginal bleeding.
  • This bleeding is the primary reason for method discontinuation globally.
  • Despite high efficacy and non-contraceptive benefits, bleeding irregularities limit patient adherence.

Purpose of the Study:

  • To investigate the mechanisms underlying unpredictable vaginal bleeding with long-acting progestogen-only contraceptives.
  • To explore the reasons for inter-individual variability in endometrial response to these methods.
  • To identify potential therapeutic targets for managing recurrent bleeding issues.

Main Methods:

  • Review of existing research on vaginal bleeding patterns and mechanisms.
  • Analysis of endometrial tissue characteristics in women experiencing bleeding irregularities.
  • Exploration of pharmacological and physiological factors influencing endometrial hemostasis.

Main Results:

  • Mechanisms contributing to fragile endometrial vessels in some users are partially understood.
  • Significant variability exists in endometrial vascular fragility and bleeding patterns among users.
  • Current treatments can manage acute bleeding but not prevent recurrence effectively.

Conclusions:

  • Understanding individual endometrial responses to progestogen-only contraceptives is crucial.
  • Further research into the biological basis of bleeding variability may lead to better long-term management strategies.
  • Addressing erratic bleeding is essential for improving the acceptability and continuation rates of these effective contraceptive methods.