Abnormal bleeding during menopause hormone therapy: insights for clinical management

Area of Science:

• Gynecology
• Endocrinology
• Reproductive Medicine

Background:

• Abnormal uterine bleeding (AUB) is a common concern during menopausal hormone therapy (HT).
• Understanding the mechanisms of AUB in this context is crucial for effective management.
• Hormone therapy regimens can influence endometrial hemostasis and bleeding patterns.

Purpose of the Study:

• To review the mechanisms underlying abnormal uterine bleeding during climacteric hormone therapy.
• To propose evidence-based strategies for controlling and treating this condition.
• To identify risk factors and optimize treatment approaches for women undergoing HT.

Main Methods:

• Systematic literature search of databases including SciELO, MEDLINE, and PubMed.
• Identification of relevant publications on normal endometrial bleeding, AUB, and HT-related bleeding.
• Synthesis of findings to inform clinical recommendations.

Main Results:

• Pre-treatment assessment for organic conditions and bleeding risk is essential.
• Individualizing HT regimens based on patient characteristics is key.
• Abnormal bleeding can be managed by modifying progestogen type, adjusting hormone doses, or changing the regimen formulation.

Conclusions:

• Tailoring hormone therapy to individual needs and identifying high-risk women are critical for preventing AUB.
• Current management focuses on optimizing existing regimens.
• Further research is needed to evaluate novel adjuvant therapies for managing AUB in women on HT.