Heavy or irregular uterine bleeding during chemotherapy
- Andrea Milbourne, MD
Andrea Milbourne, MD
- Professor of Gynecologic Oncology
- The University of Texas
- Section Editors
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Department Chair, Gynecologic Oncology
- University of Washington Medical Center
- Robert L Barbieri, MD
Robert L Barbieri, MD
- Editor-in-Chief — Obstetrics, Gynecology and Women's Health
- Section Editor — General Gynecology and Female Reproductive Endocrinology
- Kate Macy Ladd Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
Chemotherapy-induced thrombocytopenia can lead to menorrhagia (ie, heavy and prolonged menses) or irregular bleeding in premenopausal women, including adolescents , whereas uterine bleeding is a rare complication of chemotherapy-induced thrombocytopenia in postmenopausal women. Premenopausal women treated with alkylating agents are also at risk of development of hypogonadotropic amenorrhea.
This topic review will address management of menorrhagia related to chemotherapy. Ovarian failure related to anticancer drugs is discussed separately. (See "Ovarian failure due to anticancer drugs and radiation".)
There are three potential cancer-related causes of uterine bleeding:
●Bleeding directly from a genitourinary neoplasm (eg, endometrial carcinoma, gestational trophoblastic disease, cervical cancer)
●Bleeding secondary to thrombocytopenia induced by chemotherapy, radiation therapy, and/or the malignancy itself (eg, acute promyelocytic leukemia, non-Hodgkin lymphoma)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CLINICAL MANIFESTATIONS AND DIAGNOSIS
- Prevention of menorrhagia
- - GnRH agonists
- Initial therapy of menorrhagia
- - Estrogen
- - Estrogen-progestin
- - Progestin
- - Endometrial ablation
- Prevention of recurrent menorrhagia
- - Estrogen-progestin
- - Progestins
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS