Progestins have long been used to induce withdrawal bleeding in women with secondary amenorrhea. Several factors predict the efficacy of progesterone for this purpose. 5 These factors include estrogen concentrations greater than or equal to 35 pg/ mL (128 pmol/L) and endometrial thickness (the greater it is, the greater is the amount of withdrawal bleeding).

The efficacy of progestins for secondary amenorrhea also varies depending on the formulation used. For example, progesterone in oil administered intramuscularly results in withdrawal bleeding in 70% of treated patients, whereas oral MPA induces withdrawal bleeding in 95% of treated patients.15 Table 49-2 identifies the types and doses of progesterones used for inducing withdrawal bleeding in women with secondary amenorrhea. Figure 49-3 illustrates when to consider the use of progesterone for the treatment of amenorrhea.

For all patients experiencing amenorrhea, owing to the negative impact this has on bone health, it is essential that a diet rich in calcium and vitamin D be followed.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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