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Prospective Case-Control Study of Abnormal Bleeding after Outpatient Corticosteroid Injection
Elizabeth Suh-Burgmann1, Jennifer Y Liu
1The Kaiser Permanente Northern California Gynecologic Cancer Program, The Permanente Medical Group, Walnut Creek, Calif., USA.
Gynecologic and Obstetric Investigation
|November 23, 2016
Summary
Outpatient corticosteroid injections may increase abnormal vaginal bleeding in postmenopausal women. This risk was not observed in premenopausal women, indicating a menopausal status-specific effect.
Area of Science:
- Gynecology
- Endocrinology
- Rheumatology
Background:
- Corticosteroid injections are commonly used for joint and back pain.
- The potential side effects of these injections, particularly concerning bleeding, require further investigation.
Purpose of the Study:
- To evaluate the incidence of abnormal vaginal bleeding in women receiving outpatient corticosteroid injections compared to a matched control group.
- To determine if menopausal status influences the association between corticosteroid injections and abnormal bleeding.
Main Methods:
- A prospective survey study design was employed, comparing women who received corticosteroid injections (cases) with matched controls who did not.
- Surveys were mailed 45 days post-visit to collect data on menstrual history, bleeding episodes, and risk factors.
- Data analysis involved comparing bleeding proportions between groups, stratified by menopausal status.
Main Results:
- A 40% response rate was achieved from both case and control groups.
- Postmenopausal women receiving corticosteroid injections reported significantly higher rates of abnormal bleeding (17%) compared to controls (7%, p=0.02).
- No significant difference in abnormal bleeding rates was found between premenopausal cases and controls (50% vs. 43%, p=0.39).
Conclusions:
- Outpatient corticosteroid injection is associated with an increased risk of abnormal vaginal bleeding specifically in postmenopausal women.
- The findings suggest a menopausal status-dependent association, independent of BMI and hormone use.
