Metrorrhagia (Spotting)

Abnormal uterine bleeding that is not related to MENSTRUATION, usually in females without regular MENSTRUAL CYCLE. The irregular and unpredictable bleeding usually comes from a dysfunctional ENDOMETRIUM.

Also Known As:

Networked: 1675 relevant articles (78 outcomes, 151 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hemorrhage
2.	Metrorrhagia (Spotting)
3.	Menorrhagia
4.	Leiomyoma (Uterine Fibroids)
5.	Endometriosis (Adenomyosis)

Experts

1.	Archer, David F: 10 articles (10/2015 - 01/2007)
2.	Matsumura, Yasuo: 8 articles (02/2011 - 09/2002)
3.	Fraser, I S: 8 articles (08/2006 - 02/2000)
4.	Link, Andrew J: 7 articles (01/2008 - 01/2008)
5.	Labaer, Joshua: 7 articles (01/2008 - 01/2008)
6.	Hickey, M: 6 articles (08/2006 - 05/2000)
7.	Thomas, P: 5 articles (11/2014 - 01/2004)
8.	Archer, Sheila: 5 articles (01/2013 - 11/2007)
9.	Happle, Rudolf: 5 articles (07/2012 - 01/2003)
10.	Bongers, Marlies Y: 5 articles (10/2010 - 03/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Metrorrhagia:

1.	Levonorgestrel (Plan B)FDA LinkGeneric 03/15/2004 - "The levonorgestrel releasing intra uterine device is an effective treatment for dysfunctional uterine bleeding. " 10/01/2006 - "This study confirms the efficacy of the levonorgestrel-releasing intra-uterine system in the control and reduction of menstrual blood loss in patients with dysfunctional uterine bleeding. " 01/01/2005 - "Cycle control in open-label trials in women receiving up to 36 cycles of ethinylestradiol/levonorgestrel 20 microg/100 microg was generally good, with the incidence of intermenstrual bleeding being highest during the first few cycles of use and decreasing thereafter." 11/01/1998 - " The present study applied a new technique for measuring the diameter of intrauterine structures at hysteroscopy to measurement of the superficial vasculature in 34 Norplant users recruited from a family planning clinic in London, England, and in 20 controls diagnosed at the hysteroscopy clinic with ovulatory dysfunctional uterine bleeding. " 02/01/1992 - " Nevertheless, these data on breakthrough bleeding were much lower than published data from trials with other combined pills, especially those containing levonorgestrel."
2.	Oral ContraceptivesIBA 01/01/2007 - "New low-dose formulations of combination oral contraceptives (COCs) are safe and effective, but they may be associated with an increased risk of breakthrough bleeding. " 07/01/2001 - "Oral contraceptives are frequently used for treatment of dysfunctional uterine bleeding, although only one trial has been reported. " 11/01/1989 - "The Triphasic Randomized Clinical Trial study and several others suggest that intermenstrual bleeding may be experienced by at least one third of women taking oral contraceptives at one time or another. " 10/01/2006 - "Oral contraceptives and breakthrough bleeding: what patients need to know." 01/01/2005 - "Hypericum also caused breakthrough bleeding and unplanned pregnancies when used concomitantly with oral contraceptives. "
3.	HormonesIBA 01/01/2007 - "The main goal of this study was to investigate the precise hormone dysfunction that leads to dysfunctional uterine bleeding (DUB) in adolescent girls so that, with the appropriate therapy, the occurrence of organic dysfunctions of their reproductive function can be prevented. " 06/01/2005 - "Endometrial hormone receptors in women with dysfunctional uterine bleeding." 10/01/2004 - "Outcomes of extended oral contraceptive regimens with a shortened hormone-free interval to manage breakthrough bleeding." 05/01/1998 - "Pre-treatment with gonadotrophin releasing hormone agonists increased amenorrhoea and spotting rates (P = 0.03), but was only used in 5% of cases. " 01/01/1979 - "[Other treatments (besides hormone therapy) in juvenile metrorrhagia]."
4.	ProgesteroneFDA LinkGeneric 01/01/2009 - "On the basis of conducted clinical study the authors confirm the preventive effect of the micronized progesterone, as an effective and safe alternative in treating of premenopausal women with dysfunctional uterine bleeding." 12/01/2009 - "Efficacy of micronised vaginal progesterone versus oral dydrogestrone in the treatment of irregular dysfunctional uterine bleeding: a pilot randomised controlled trial." 12/01/2009 - "Vaginal micronised progesterone could be an alternative to oral preparations in the treatment of dysfunctional uterine bleeding. " 04/01/1997 - "Twenty-one women (group II) received oral natural micronised progesterone (oral P) 100 mg daily during 25 calendar days each month, and 19 women (group III) used vaginal natural micronised progesterone (vaginal P) 100-200 mg daily during 25 calendar days each month (higher dose if spotting occurred). " 01/01/1996 - "Finally, programmed cell death and apoptosis appear to occur in endometrial stroma after prolonged exposure to progesterone and may contribute to breakthrough bleeding. "
5.	Estrogens (Estrogen)FDA Link 10/01/2013 - "To study the effect of estrogen on anovulatory dysfunctional uterine bleeding (ADUB). " 01/01/2000 - "One of the most common side effects of the low-dosed estrogen monophasic preparations with selective progestin are breakthrough bleedings and spotting. " 06/17/1997 - "Thus, the continuous production of estrogen with endometrial stimulation is the basic cause of dysfunctional uterine bleeding. " 01/01/1996 - "Continuous combined therapy with estrogen and progestogen taken every day causes no withdrawal bleed, though some will have light breakthrough bleeding for the initial 2 or 3 months. " 02/01/1994 - "[Metrorrhagia caused by estrogen-progestin combinations]."
6.	Ethinyl Estradiol (Estinyl)FDA LinkGeneric 01/01/1946 - "Ethinyl estradiol in the treatment of metrorrhagia." 10/01/1996 - " Among this subgroup, only ethinyl estradiol alone reduced significantly (p 0.02) the number of bleeding/spotting days during the 21-day treatment period. " 10/01/1996 - " On average, women treated with ethinyl estradiol had their bleeding episode shortened by 1 bleeding day and 3 spotting days. " 09/01/2007 - "The use of ethinyl estradiol 10 microg pills in place of the seven placebo pills addresses the problems posed by 21/7 formulations of low-dose birth-control pills, which allow early stimulation of ovarian follicles, and of the early 84/7 formulations, which had higher rates of unscheduled bleeding and spotting." 10/01/1996 - " In the 90 days after treatment, both ethinyl estradiol and the combined pill significantly (p 0.05) reduced bleeding/spotting compared to the 90 days preceding treatment; moreover, the length of each bleeding/spotting episode was significantly (p 0.05) shorter. "
7.	ethynylestradiol mixture with norethindrone (Zoran)IBA 07/01/1984 - "Clinical studies in the US, Canada, and France have shown that Ortho-Novum 7/7/7 is effective and safe, that it reduces midcycle breakthrough bleeding sometimes seen in patients on biphasic therapy, that side effects occur infrequently, and that metabolic impact is low. " 12/01/1986 - " Later studies showed that intermenstrual bleeding in the early cycles of Triella use later diminished." 09/01/1990 - "Loestrin subjects had a rate of occurrence (31% of cycles) for intermenstrual bleeding (IMB) comparable to the rates for subjects on the phasic preparations (36%, 37% and 37%, respectively). " 05/01/2000 - "For each of the months of the study, the incidence of breakthrough bleeding/spotting was lower in the Cyclessa group than the Ortho-Novum 7/7/7 group (breakthrough bleeding, p = 0.006; breakthrough spotting, p = 0.001). " 12/01/1987 - "Women in the Brevicon group reported significantly more (p less than 0.05) intermenstrual bleeding, nausea, headaches, dizziness and vaginal discharge than women in the Norinyl 1/35 group. "
8.	Danazol (Azol)FDA LinkGeneric 06/10/2002 - "To assess the effect of danazol pretreatment in women undergoing endometrial resection for dysfunctional uterine bleeding. " 07/01/1999 - "Altered uterine artery blood flow impedance after danazol therapy: possible mode of action in dysfunctional uterine bleeding." 06/01/1991 - "[Effects of danazol on the endometrium during peri-menopausal meno-metrorrhagia]." 08/01/1985 - "Treatment of dysfunctional uterine bleeding with danazol." 10/01/1983 - "However, the significant disadvantages of danazol include androgenic side effects, breakthrough bleeding, prolonged treatment time and high cost. "
9.	Conjugated (USP) Estrogens (Premarin)FDA Link 03/01/1982 - "The present study was conducted on 34 patients in a randomized double-blind fashion to evaluate the efficacy of treating dysfunctional uterine bleeding with intravenous Premarin. " 03/01/1982 - "Use of intravenous Premarin in the treatment of dysfunctional uterine bleeding--a double-blind randomized control study." 03/01/2003 - "A 69-year-old woman presented with vaginal spotting while on Premarin. " 01/01/1977 - "Paradoxical secretory changes are described in benign endometria curetted for breakthrough bleeding in postmenopausal women on cyclic low dosage Premarin therapy. " 05/01/1994 - "There was no bleeding or spotting in 75.5% of the cycles for patients who took conjugated estrogens alone. "
10.	Progestins (Progestagens)IBA 11/01/1992 - "Cycle control with all three progestogens is improved, with much lower incidence of intermenstrual bleeding (IMB). " 04/15/2004 - "Medical management of anovulatory dysfunctional uterine bleeding may include oral contraceptive pills or cyclic progestins. " 10/15/2000 - "Adolescents and perimenopausal women may require progestational agents for the treatment of dysfunctional uterine bleeding resulting from anovulatory cycles. " 01/02/1998 - "Direct delivery of progestogens to the uterus may be of use in the treatment of dysfunctional uterine bleeding and the sequelae of the menopause as it has the potential to overcome the problems of systemic administration. " 05/01/1997 - "Rapid saturation of the endometrium with progestogens seems to be an highly effective mode of treatment for excessive dysfunctional uterine bleeding in adolescents."

Therapies and Procedures

1.	Endometrial Ablation Techniques 05/01/2008 - "To evaluate the efficacy of thermal balloon endometrial ablation in the treatment of dysfunctional uterine bleeding, and to identify the possible predictive factors for a successful outcome. " 03/01/2006 - "Endometrial ablation is an effective treatment for dysfunctional uterine bleeding. " 11/01/2005 - "Microwave endometrial ablation is an effective treatment for dysfunctional uterine bleeding. " 01/01/2009 - "Endometrial ablation with the Thermablate system is a safe and effective therapy for dysfunctional uterine bleeding when other therapies are contraindicated or have been tried and failed." 10/01/2002 - "Endometrial ablation is a safe and effective hysteroscopic procedure for dysfunctional uterine bleeding, its prognosis depends of several factors, that shows the importance of patients selection."
2.	Hysterectomy 01/01/2003 - "After successful treatment of dysfunctional uterine bleeding, either by hysterectomy or uterus-saving alternatives, the majority of women report experiencing improved sexual functioning. " 12/01/2007 - "These techniques have been shown to be effective and safe alternatives to hysterectomy for dysfunctional uterine bleeding resulting in reduction in menstrual blood loss and dysmenorrhoea, correction of anaemia and improvement in quality of life. " 09/01/1996 - "Tow hundred and four women with dysfunctional uterine bleeding who, when recruited to the initial study two years previously, were aged less than 50 years, weighed less than 100 kg, and who would otherwise have undergone hysterectomy. " 10/01/2014 - "Hysterectomy was needed in only one case with dysfunctional uterine bleeding and an enlarged uterus. " 04/01/2014 - "We present a rare case of incidentally detected cavernous haemangioma of the fallopian tube in a post menopausal female who underwent hysterectomy and bilateral salphingoopherectomy for dysfunctional uterine bleeding. "
3.	Contraception (Birth Control) 09/01/2006 - "Cost-effectiveness of treatments for dysfunctional uterine bleeding in women who need contraception." 12/01/2003 - "Women taking oral contraceptive pills should be counseled to expect breakthrough bleeding and should consider adding a barrier method of contraception when consuming St Johns wort." 03/01/2003 - "In women taking progestin-only contraception, endometrial perivascular alpha smooth muscle actin is reduced in those who suffer from breakthrough bleeding compared to those that don't. " 03/01/2002 - "A significant problem with progestogen-only methods of contraception is the induction of breakthrough bleeding. " 12/01/2000 - "Because after OC discontinuation most women switch to a less-effective method, or no method, of contraception, an increase in breakthrough bleeding could ultimately result in an increase in unintended pregnancy. "
4.	Laser Therapy (Surgery, Laser) 06/01/1995 - "With good techniques endometrial laser ablation can be a safe and effective treatment for dysfunctional uterine bleeding. " 01/01/1995 - "This study, the largest one published from a single institution, with a mean follow-up duration of 15 months, confirms that endometrial laser ablation is a safe and effective treatment for dysfunctional uterine bleeding." 09/01/1995 - "Endometrial laser ablation is a major advance in the management of dysfunctional uterine bleeding, especially in patients who would otherwise have had a hysterectomy." 10/15/1994 - "Randomised trial of hysterectomy, endometrial laser ablation, and transcervical endometrial resection for dysfunctional uterine bleeding." 10/15/1994 - "To evaluate the effectiveness and safety of endometrial laser ablation and transcervical resection of the endometrium compared with hysterectomy in the surgical treatment of women with dysfunctional uterine bleeding. "
5.	Intrauterine Devices (Intrauterine Device) 04/01/1995 - "Endometrial morphometry in users of intrauterine contraceptive devices and women with ovulatory dysfunctional uterine bleeding: a comparison with normal endometrium." 01/01/1995 - "Spotting was more common in the intrauterine contraceptive device group than in the oral therapy group for the first 3 months. " 09/01/1988 - "Women who used an intrauterine contraceptive device (IUCD) reported prolonged, heavy, and frequent periods and intermenstrual bleeding more often than other women, but they did not report painful periods with undue frequency. " 03/01/1997 - "Spotting was more common in the intrauterine device group than in the vaginal ring group. " 09/01/2013 - "Almost half of participants (46%) had responses to the question "Do you have any questions or concerns about your intrauterine device?" that fell into the following categories: spotting/bleeding (16%), cramping/pain (15%), string management (10%), expulsion concern (5%). "