Administration of Medroxprogesterone Acetate after Endomyometrial Resection

Area of Science:

• Gynecology
• Reproductive Medicine
• Minimally Invasive Surgery

Background:

• Menorrhagia, characterized by heavy menstrual bleeding, affects numerous women of reproductive age.
• Endometrial resection is a surgical option for managing menorrhagia, but achieving complete cessation of menses (amenorrhea) can vary.
• The role of postoperative hormonal therapy in enhancing outcomes after endometrial resection requires further investigation.

Purpose of the Study:

• To evaluate the efficacy of postoperative medroxyprogesterone acetate (MPA) in increasing amenorrhea rates after endometrial resection.
• To assess the impact of MPA on menstrual bleeding patterns in women with menorrhagia undergoing endometrial resection.

Main Methods:

• Seventy women with menorrhagia underwent transvaginal sonography, hysteroscopy, and endometrial biopsy.
• All patients received endometrial resection using a resectoscope, followed by rollerball coagulation, with 1.5% glycine as the distention medium.
• Forty women received postoperative oral MPA (20 mg/day for 2 months), while the remaining received a placebo; all were followed for 6 months.

Main Results:

• Hysteroscopy identified normal uterine cavities in 60 patients, polyps in 4, and submucous myomas in 6.
• Endometrial biopsy showed normal histology in 67 women and hyperplasia in 3.
• Amenorrhea occurred in 40% of the placebo group versus 70% in the MPA group, indicating a significant difference.

Conclusions:

• Postoperative treatment with medroxyprogesterone acetate (MPA) appears to increase the frequency of amenorrhea after endometrial resection.
• MPA may be a beneficial adjunct therapy for women undergoing endometrial resection to achieve amenorrhea and manage menorrhagia.