Therapeutic amenorrhea in patients at risk for thrombocytopenia.
To examine the need for and evaluate the method of menses suppression in women at risk for thrombocytopenia. A systematic review of the published literature in MEDLINE using the search terms thrombocytopenia, menorrhagia, therapeutic amenorrhea, progestin intrauterine device, combination oral contraceptive--extended and cyclic, gonadotropin releasing hormone agonist, danazol, and progestins. There are an increased number of reproductive age women at risk for thrombocytopenia who would benefit from menses suppression. A number of effective medical regimens are available. In patients who fail medical therapy, endometrial ablation appears to be effective in women with thrombocytopenia. As a result of the increased number of women at risk for thrombocytopenia, there is a need for therapeutic amenorrhea. The type of regimen selected depends upon the patients need for contraception and the ability to tolerate estrogen-containing medications. For women who fail medical therapy, there are surgical options, which are associated with less morbidity than hysterectomy.
Martin-Johnston
Meredith K
MK
Illinois Masonic Medical Center, Chicago, Illinois, USA.
Okoji
Olanma Y
OY
Armstrong
Alicia
A
D000328:Adult; D015897:Comorbidity; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D003613:Danazol / Q000494:pharmacology / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007044:Hysterectomy; D007434:Intrauterine Devices; D016912:Levonorgestrel / Q000008:administration & dosage; D008595:Menorrhagia / Q000453:epidemiology* / Q000517:prevention & control; D008598:Menstruation / Q000187:drug effects*; D013921:Thrombocytopenia / Q000453:epidemiology* / Q000517:prevention & control*
D003271:Contraceptive Agents, Female; D004965:Estrogen Antagonists; D007987:Gonadotropin-Releasing Hormone; D016912:Levonorgestrel; D003613:Danazol