Vaginal Bleeding: It’s not an ectopic. How do I stop it?

19 Jun

*   High dose Oral contraceptives (35 mcg of ethinyl estradiol) will cause bleeding to subside within 48 hours.

*   High dose PO Estrogen: Premarin 2.5 mg 4 times daily until bleeding subsides*   Tapered regimen often used (5 on day 1, 4 on day 2, 3 on day 3, etc, then complete pack 1 tablet daily)

*   Women can get nausea from high dose estrogen, so give anti-emetics as well.

  High dose progestins can be used to treat hemorrhage related to anovulation (medroxyprogesterone BID, mestrol BID, or norethindrone BID)

*   These are contraindicated in patients with known clotting disorders, h/o VTE, MI, CVA, malignancy.

Submitted by W. Brooks.

Source: UpToDate.com: Managing an episode of acute or prolonged uterine bleeding; picture

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