Effects Of MPA On Menopausal Transition Period Dysfunctional Uterine Bleeding

ObjectiveTo review the clinical effect of Medroxyprogesterone Acetate (MPA) in the treatment of the menopausal transition period dysfunctional uterine bleeding.Method1.General condition of the patients:A retrospective study of65patients with menopausal transition period dysfunctional uterine bleeding in Provincial Hospital Affiliated to Shandong University from July2001to March2012which were treated with MPA (n=30) or Norethindrone (n=35) respectively.2.Clinical treatment:Dosage decreasing method was used in hemostasis, dosage increasing method was used to decrease menstruation amount of bleeding next time.MPA group:Dosage decreasing method of MPA (250mg/tablets).The initial dose:500mg;the following four weeks,250mg once.The first week:once daily; the second week:stop one time every two days:the third week:once every other day; the forth week:once every two days.Norethindrone group:Dosage decreasing method of Norethindrone (0.625mg/tablets).The first week:12tablets3times daily, every time a week decrease2tablets for four weeks.Patients in both groups used dosage increasing method of Norethindrone in the 5th day of the withdrawal bleeding, The first week:4tablets3times daily, every time a week increase1tablet for3weeks.3.0utcome measures:①Time of controlling the bleeding and stopping bleeding.②Hemostatic efficacy were graded as markedly effective, effective and ineffective, markedly effective and effective were included in the total efficiency.③Adverse reactions.④The menstruation of the3rd treatment cycles, the change of endometrial thickness and the rising of Hb level.4.Statistical methods:All data were analyzed by SPSS16.0, the t-test, Chi-Squared and analysis of variance was employed to the data analysis.Results1.Treatment time:The time of controlling bleeding and stopping bleeding in the MPA group were lower than the Norethindrone group, the cases of rapid control of bleeding (%) and rapid hemostasis (%) were higher in the MPA group, there was significant difference (P=0.029;0.011respectively).2.Treatment efficacy:The cases of markedly effective (%), effective (%) and total efficiency of the MPA group were higher than those in the Norethindrone group, cases of ineffective (%) was lower than the Norethindrone group, the effectiveness of the treatment in both groups had significantly difference (P=0.013).3. Adverse reactions were observed in3cases in the MPA group,4cases in the Norethindrone group, such as increased weight due to sodium and water storage, nausea, headache, dizziness. Symptoms were released or disappeared after drug withdrawal, there was no significant difference(P>0.05).4.The menstrual flow of the3rd cycle, the cases of the menstrual blood loss were25in MPA group and20in Norethindrone group (P=0.044).There were no significant difference in the rate of irregular vaginal bleeding during follow-up (P>0.05). and in the relapse rate after drug withdrawal (P>0.05). 5.Endometrial thickness:the endometrial thickness of two groups were significantly thinner(P=0.000;0.003respectively).The thin degree of the MPA group was significantly greater than Norethindrone group(P=0.026).6.Rising of Hb level:the rising of Hb level had a mean value of20.5g/L in the MPA group, compared to a mean value of8.4g/L in the Norethindrone group (P=0.000).Conclusions1. Compared with conventional treatment. MPA in treatment of the menopausal transition period dysfunctional uterine bleeding has a better clinical efficacy.2. There is no severe adverse reactions after treatment,only mild such as increased weight due to sodium and water storage, nausea, headache, dizziness, no need treatment.