Human Reproduction, Vol 13, 188-191, Copyright © 1998 by Oxford University Press
A Faundes, F Alvarez, V Brache and L Cochon
The objective of this study was to measure oestradiol, progesterone and
endometrial development among Norplant implant users with bleeding
complaints. Seventy-six volunteers complaining of prolonged/frequent
bleeding were enrolled. Oestradiol, progesterone and endometrial thickness
(assessed by vaginal ultrasound) were determined at that visit. Two thirds
of the women had low oestradiol (< 50 pg/ml) and all except one had low
progesterone concentrations (< 3 ng/ml). A total of 68% had a very thin
endometrium (< 3 mm). A subgroup of 21 women were followed twice a week
for 8 consecutive weeks. Oestradiol and progesterone concentrations
remained low during the continuous bleeding episodes or short bleeding-free
intervals (< or = 15 days), yet increased five- to sixfold (253.4 +/-
142.2 pg/ml) in long bleeding- free intervals. Endometrial thickness
remained thin irrespective of the differences in bleeding patterns and
oestradiol. We conclude that Norplant implant users with bleeding
complaints are usually characterized by low oestradiol concentrations,
absence of luteal activity and thin endometrium. A good correlation exists
with increasing oestradiol concentrations and longer bleeding-free
intervals, but this is not manifested by increased endometrial thickness.
However, few subjects bleed with relatively high oestradiol concentrations,
therefore a better understanding of the intimate disturbances related to
endometrial bleeding in users of long-acting progestins is still pending.
ARTICLES
Endometrial thickness and oestradiol concentration in women with bleeding complaints during use of Norplant implants
Centro de Pesquisa das Doencas Materno-Infantis de Campinas, Departamento de Ginecologia e Obstetricia, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, SP, Brasil.
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