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Monday, 2 December 2013

Hemorrhaging: Breakthrough bleeding - The Preventions

Hemorrhaging is also known as bleeding or abnormal bleeding as a result of blood loss due to internal.external leaking from blood vessels or through the skin.

H. Breakthrough bleeding 
Breakthrough bleeding is defined as a condition of an abnormal flow of blood from the uterus that occurs between menstrual periods especially due to irregular sloughing of the endometrium in women on contraceptive hormones(1).
Prevention 
1. Lose weight
Accumulation of fat in obese women can cause the increased risk of breakthrough bleeding due to ongoing production of estrogen.

2. Smoking
Smoking can interfere with menstrual control of oral contraceptive that can lead to breakthrough bleeding.

3. Reduce intake of enzyme inducers

4.  Mifepristone
in the study to determine if mifepristone would decrease BTB in new starters of DMPA. Twenty regularly cycling women who were new starters of DMPA were randomized to receive 50 mg of mifepristone or placebo every 2 weeks for 24 weeks, researchers at the University of Southern California Keck School of Medicine, showed that percent days of BTB and number of cycles with bleeding intervals > or =8 and > or =14 days were evaluated using daily bleeding diaries. Ovulation was determined by measuring thrice-weekly urinary metabolites of estrogen and progesterone. Endometrial concentrations of ER and PR were determined by immunohistochemistry. Mifepristone significantly decreased the percent days of BTB and the number of cycles with prolonged bleeding intervals when compared to placebo. No subject ovulated in either group. ER immunostaining increased and PR immunostaining decreased after mifepristone treatment. In conclusion, a 50 mg dose of mifepristone taken every 2 weeks decreases the incidence of BTB in new starters of DMPA. This effect may be due to modulation of endometrial estrogen and progesterone receptors(6).

5. Etc. 
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Sources
(1) http://www.merriam-webster.com/medical/breakthrough%20bleeding
(6) http://www.ncbi.nlm.nih.gov/pubmed/14668006