title: A functional model for progestogen-induced breakthrough bleeding.
abstract: During the past 5 years, a number of important advances have been made in our understanding of the mechanisms of sex steroid-induced breakthrough bleeding (BTB). These observations suggest that superficial endometrial vascular fragility may be the mechanism underlying BTB, and molecular changes in the microvasculature as well as hysteroscopic observations have supported this hypothesis. This paper aims to present a unified picture of our current understanding of BTB, particularly that associated with progestogens, to indicate current gaps in our knowledge and possible directions for future research.
authors.affiliation: Department of Obstetrics and Gynaecology, Imperial College School of Medicine at St Mary's, London, UK. m.hickey@ic.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Hickey
authors.forename: I S
authors.initials: IS
authors.lastname: Fraser
mesh_terms: D004717:Endometrium / Q000098:blood supply / Q000187:drug effects; D004848:Epithelium / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D008833:Microcirculation / Q000187:drug effects / Q000473:pathology; D008954:Models, Biological; D011372:Progestins / Q000009:adverse effects* / Q000494:pharmacology; D014592:Uterine Hemorrhage / Q000139:chemically induced* / Q000473:pathology
chemical_list: D011372:Progestins