Norplant users with irregular bleeding. Ultrasonographic assessment and evaluation of serum concentrations of estradiol and progesterone.
OBJECTIVE
To determine the changes in thickness and pattern of endometrium among Norplant (Leiras, Leiras Oy, Turku, Finland) users who have irregular bleeding and to correlate these changes with estradiol and progestrone concentrations.


METHODS
Ultrasonographic evaluation (vaginal ultrasound) and serum sampling were performed on Norplant users who presented with complaints of bleeding at their first visit to the Family Planning Clinic, Department of Obstetrics and Gynecology, Chulalongkong Hospital, Bangkok, Thailand, between October 1, 1998, and March 31, 1999.


RESULTS
A total of 85% (44/52 cases) of the subjects had estradiol concentrations < 50 pg/mL, and none had any luteal activity (progesterone concentration < 3 ng/mL). The endometrial thickness remained thin and very thin (3-6 mm = 50%, < 3 mm = 48%). A hyperechoic pattern in the endometrium was found in 90% of the subjects. There was a weak, negative correlation between estradiol concentration and endometrial thickness (P < .05, r = -.337).


CONCLUSIONS
Norplant users with irregular bleeding were usually characterized by low estradiol concentrations, absence of luteal activity and a thin, hyperechoic pattern in the endometrium.
Kaewrudee
S
S
Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Srinagarind Hospital, Mittraphap Road, Muang, Khon Kaen 4000, Thailand.
Taneepanichskul
S
S
D000328:Adult; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000494:pharmacology*; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000187:drug effects*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000009:adverse effects / Q000494:pharmacology*; D008599:Menstruation Disturbances / Q000209:etiology*; D011374:Progesterone / Q000097:blood; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000209:etiology*
D003271:Contraceptive Agents, Female; D011374:Progesterone; D004958:Estradiol; D016912:Levonorgestrel