Prevalence of Menorrhagia
Menstrual Content
Normal Menstrual Cycles
Menstrual Loss Measurement
Causes of Menorrhagia
Sterilisation And Menorrhagia
Anaemia and Menorrhagia
Intermenstrual Bleeding
Menorrhagia Investigation
Hysteroscopy D and C Endometrial
Biopsy
Hysteroscopy D and C Endometrial
Biopsy
Treatments for Menorrhagia
Mirena-IUS
Endometrial Ablation
Hysterectomy
Support Groups
Endometrial effects of intrauterine levonorgestrel.
Guttinger A, Critchley HO.
Division of Reproductive and Developmental Sciences, The Queen's Medical Research Institute, Centre for Reproductive Biology, The University of Edinburgh, EH16 4TJ Edinburgh, UK.
Local intrauterine delivery of levonorgestrel (LNG) results in extensive decidualization of endometrial stromal cells, atrophy of the glandular and surface epithelium and changes in vascular morphology (suppression of spiral artery formation and presence of large dilated vessels). With endometrial exposure to LNG, there is down-regulation of sex steroid receptors in all cellular components. As a consequence of endometrial sex steroid receptor down-regulation, there is perturbation of progesterone-regulated locally acting mediators, and the integrity of blood vessel walls is disturbed. Thus, intrauterine LNG administration results in modulation of local mediators regulating endometrial function. To date, no single factor has been identified where the expression correlates closely with unscheduled breakthrough bleeding (BTB). BTB is a common side effect and reason for discontinuation of LNG-IUS use. Much remains to be determined about the mechanisms involved in suppression of menstruation, BTB episodes and the local endometrial environment with local LNG administration.
Contraception. 2007 Jun;75(6 Suppl):S93-8.
Endometrial effects of intrauterine levonorgestrel.
Guttinger A, Critchley HO.
Division of Reproductive and Developmental Sciences, The Queen's Medical Research Institute, Centre for Reproductive Biology, The University of Edinburgh, EH16 4TJ Edinburgh, UK.
Local intrauterine delivery of levonorgestrel (LNG) results in extensive decidualization of endometrial stromal cells, atrophy of the glandular and surface epithelium and changes in vascular morphology (suppression of spiral artery formation and presence of large dilated vessels). With endometrial exposure to LNG, there is down-regulation of sex steroid receptors in all cellular components. As a consequence of endometrial sex steroid receptor down-regulation, there is perturbation of progesterone-regulated locally acting mediators, and the integrity of blood vessel walls is disturbed. Thus, intrauterine LNG administration results in modulation of local mediators regulating endometrial function. To date, no single factor has been identified where the expression correlates closely with unscheduled breakthrough bleeding (BTB). BTB is a common side effect and reason for discontinuation of LNG-IUS use. Much remains to be determined about the mechanisms involved in suppression of menstruation, BTB episodes and the local endometrial environment with local LNG administration.
Please click on the required question.
- 1 Are heavy periods a common problem?
- 2 What is in my menstrual flow?
- 3 What range of menstrual cycle length is considered to be normal?
- 4 How can menstrual blood loss be measured?
- 5 How can I tell if my periods are abnormally heavy?
- 6 What could be the cause of my very heavy menstrual periods?
- 7 I have been sterilised. Could this be the cause of my heavy periods?
- 8 Should I have tests to find the reason for my heavy periods?
- 9 How will my heavy period problems be investigated?
- 10 What is meant by anaemia due to heavy periods?
- 11 What is intermenstrual bleeding?
- 12 What is a hysteroscopy and D and C?
- 13 What is cervical cautery?
- 14 What happens after the D and C?
- 15 What treatments are available for my heavy periods?
- 16 What are the medical treatments available for heavy periods?
- 17 How do the various medical treatments for heavy periods work?
- 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
- 19 What is a hysterectomy?
- 20 What are the indications for hysterectomy?
- 21 What are the risks (complications) of hysterectomy?
- 22 What is vault granulation?
- 23 What are the different types of hysterectomy?
- 24 Is it essential to remove the neck of the womb at hysterectomy?
- 25 Should my ovaries be removed or conserved during hysterectomy?
- 26 How long will I be in hospital when I have my hysterectomy?
- 27 I have had a hysterectomy. Do I still need to have smear tests?
- 28 What are the other surgical alternatives to hysterectomy?
- 29 How do endometrial ablation and hysterectomy compare?
- 30 Are there any psychological effects following hysterectomy?
- 31 How do we decide the best treatment for my period problems?
- 32 Could I have some recommended hysterectomy support groups?
- 33 Are there any support groups?
- Intermenstrual Bleeding - Bleeding between periods.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
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