Etiología y tratamiento | 26 OCT 15
Metrorragia en mujeres premenopáusicas no embarazadas
El sangrado vaginal no programado se produce fuera del período menstrual normal o es secundario al uso de anticonceptivos orales, es una razón común de consulta en atención primaria por las mujeres en edad reproductiva.
Autor: Dras. Mary Ann Lumsden, Ailsa Gebbie, Cathrine Holland. BMJ 2013;346:f3251
INDICE:  1. Artículo | 2. Referencias

1 Warner P, Critchley HO, Lumsden MA, Campbell-Brown M, Douglas A, Murray G. Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral and management. BMJ 2001;323:24-8.
2 Office for National Statistics. Cancer statistics registrations. Registrations of cancers diagnosed in England 2003. ONS, 2005.
3 Kjerulff KJ, Langenberg P, Seidman JD, Stolley PD, Guzinsi GM. Uterine leiomyomas. Racial differences in severity, symptoms and age at diagnosis. J Reprod Med 1995;41:483-90.
4 Dreisler E, Sorensen S, Ibsen PH, Lose G. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years. Ultrasound Obstet Gynecol2009;33:102-8.
5 Buttram VC, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 1981;36:433-45.
6 Harlow BL, Weiss NS, Lafton S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst 1986;76:399-402.
7 Lee SC, Kaunitz AM, Sanchez-Ramos L, Rhatigan RM. The oncogenic potential of endometrial polyps: a systematic review and meta-analysis. Obstet Gynecol 2010;116:1197-205.
8 Treloar AE, Boynton RE, Behn BG, Brown BW. Variation of the human menstrual cycle throughout life. Int J Fertil 1967;12:77-126.
9 Faculty of Sexual and Reproductive Healthcare Clinical Guidance. Intra-uterine contraception. 2007. pdf.
10 Rosenthal AN, Panoskaltsis T, Smith T, Soutter WP. The frequency of significant pathology in women attending a general gynaecological service for postcoital bleeding. Br J Obstet Gynaecol 2001;108:103-6.
11 Sahu B, Latheef R, Magd SA. Prevalence of pathology in women attending colposcopy for postcoital bleeding with negative cytology. Arch Gynecol Obstet 2007;276:471-3.
12 Cancer Research UK. CancerStats—Cancer statistics for the UK. 2009. www.
13 Henderson HJ. Why lesbians should be encouraged to have regular cervical screening. J Fam Plann Reprod Health 2009;35:49-52.
14 Royal College of Obstetricians and Gynaecologists. Faculty of Sexual and Reproductive Healthcare clinical guidance. Management of unscheduled bleeding in women using hormonal contraception. 2009.
15 Gallo MF, Nanda K, Grimes DA, Lopez LM, Schulz KF. 20 μg versus >30 μg estrogen combined oral contraceptives for contraception. Cochrane Database Syst Rev 2011;1:CD003989.
16 Endrikat J, Gerlinger C, Plettig K, Wessel J, Schmidt W, Grubb G, et al. A meta-analysis on the correlation between ovarian activity and the incidence of intermenstrual bleeding during low-dose oral contraceptive use. Gynecol Endocrinol 2003;17:107-14.
17 Hickey M, Fraser IS. Clinical implications of disturbances of uterine vascular morphology and function. Baillieres Best Pract Res Clin Obstet Gynaecol 2000;14:937-51.
18 Szarewski A. Sisters doing it for themselves. J Fam Plann Reprod Health Care ;2009;35:71-2.
19 Oddsson K, Liefels-Fischer B, Wiel-Masson D, de Melo NR, Benedetto C, Verhoeven CHJ, et al. Superior cycle control with a contraceptive vaginal ring compared with an oral contraceptive containing 30 mcg ethinylestradiol and 150 mcg levonorgestrel: a randomized trial. Hum Reprod 2005;20:557-62.
20 Public Health England. Colposcopy and Programme Management. Guidelines for the NHS cervical screening programme. No 20. 2010:15-6.
21 Public Health England. Clinical practice guidance for the assessment of young women aged 20-24 with abnormal vaginal bleeding. 2010.
22 National Institute for Health and Care Excellence. Referral guidelines for suspected cancer. CG27. 2005.
23 AAGL Practice Report. Practice guidelines for the diagnosis and management of endometrial polyps. Journal of Minimally Invasive Gynaecology 2012;19:3-10.
24 Farquhar C, Ekeroma A, Furness S, Arroll B. A systematic review of transvaginal ulatrasonography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women. Acta Obstet Gynaecol Scand 2003;82:493-504.
25 Critchley HO, Warner P, Lee AJ. Evaluation of abnormal uterine bleeding: comparison of 3 outpatient procedures within cohorts defined by age and menopausal status. Health Technol Assess 2001;8:iii-iv, 1-139.
26 National Institute for Health and Care Excellence. Heavy menstrual bleeding: investigation and management. CG44. 2007.
27 ESHRE Capri Workshop Group. Endometrial bleeding. Hum Reprod Update 2007;13:421-31.
28 Lumsden MA. Modern management of fibroids. Obstet Gynaecol Reprod Med2009;20:82-6.
29 Donnez J, Tatarchuk T, Bouchard P, Puscasiu L, Zakharenko N, Ivanova T, et al. Ulipristal acetate versus placebo for fibroid treatment before surgery. N Engl J Med 2012;366:409-20.
30 Gupta JK, Sinha A, Lumsden MA, Hickey M. Uterine artery embolisation for uterine fibroids. Cochrane Database Syst Rev 2012;5:CD005073.
For personal use only: See rights and reprints Subscribe: BMJ 2013;346:f3251 doi: 10.1136/bmj.f3251 (Published 4 June 2013) Page 5 of 10
31 National Institute for Health and Care Excellence. Long-acting reversible contraception. CG30. 2005. For personal use only: See rights and reprints Subscribe: BMJ 2013;346:f3251 doi: 10.1136/bmj.f3251 (Published 4 June 2013) Page 6 of 10
32 Abdel-Aleem H, d’Arcangues C, Vogelsong K, Gulmezoglu AM. Treatment of vaginal bleeding irregularities induced by progestin only contraceptives. Cochrane Database Syst Rev 2007;4:CD003449.
33 Hickey M, Higham H, Fraser I. Progestogens with or without oestrogen for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev 2012;9:CD001895.
34 Orbo A, Arnes M, Hancke C, Vereide AB, Pettersen I, Larsen K. Treatment results of endometrial hyperplasia after prospective D-score classification—a follow-up study comparing effect of LNG-IUD and oral progestins versus observation only. Gynecol Oncol2008;111:68-73.
35 WHO. Selective practice recommendations for contraceptive use. 2nd ed. 2004. Updated 2008.



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