title: Progestogen only contraception and endometrial break through bleeding.
abstract: Progestogen only contraceptives (POC) provide a safe and effective method of fertility regulation. Unfortunately, they are commonly associated with the problem of endometrial break through bleeding (BTB), often leading to discontinuation of use. An increase in endometrial vascular fragility has been demonstrated as an important mechanism that contributes to BTB but our understanding of the interaction between exogenous steroid use and endometrial vasculature remains incomplete. This review sets out to describe a number of commonly used POC, their effects on endometrial morphology and possible molecular and cellular mechanisms that may lead to unscheduled bleeding.
authors.affiliation: Department of Reproductive and Developmental Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Oliver P Milling
authors.initials: OP
authors.lastname: Smith
authors.forename: Hilary O D
authors.initials: HO
authors.lastname: Critchley
mesh_terms: D043925:Angiogenesis Inducing Agents / Q000378:metabolism; D003271:Contraceptive Agents, Female / Q000633:toxicity*; D004717:Endometrium / Q000098:blood supply* / Q000187:drug effects*; D005260:Female; D006801:Humans; D008796:Metrorrhagia / Q000139:chemically induced* / Q000473:pathology*; D011374:Progesterone / Q000633:toxicity*; D011987:Receptors, Steroid / Q000378:metabolism
chemical_list: D043925:Angiogenesis Inducing Agents; D003271:Contraceptive Agents, Female; D011987:Receptors, Steroid; D011374:Progesterone