Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation

Practice patterns and attitudes about treating abnormal uterine bleeding: a national survey of obstetricians and gynecologists

OBJECTIVE

We sought to examine the practice patterns and attitudes of obstetricians and gynecologists surrounding treatment of abnormal uterine bleeding (AUB).

STUDY DESIGN

We conducted a cross-sectional study of members of the American College of Obstetricians and Gynecologists. Surveys, which were distributed using a sequential mixed method (both web- and mail-based) approach, included questions about practice characteristics, practice patterns, and knowledge about treatment options for AUB.

RESULTS

Of 802 questionnaires, 417 were returned (52%). The most commonly selected first-line choice for AUB treatment was combined oral contraceptives (97% anovulatory, 98% ovulatory). The levonorgestrel intrauterine system was the next most frequently selected option (63% anovulatory, 53% ovulatory). Respondents did not score high on questions about the effectiveness of treatments for AUB. Only 25% (n = 86) answered at least 2 of the 3 questions correctly.

CONCLUSION

Continued education is necessary to increase the utilization of the most effective treatment options for AUB.

Challenges in the gynecologic care of premenopausal women with breast cancer

Premenopausal women with a new diagnosis of breast cancer are faced with many challenges. Providing health care for issues such as gynecologic comorbidities, reproductive health concerns, and vasomotor symptom control can be complicated because of the risks of hormone treatments and the adverse effects of adjuvant therapies. It is paramount that health care professionals understand and be knowledgeable about hormonal and nonhormonal treatments and their pharmacological parameters so they can offer appropriate care to women who have breast cancer, with the goal of improving quality of life. Articles for this review were identified by searching the PubMed database with no date limitations. The following search terms were used: abnormal uterine bleeding, physiologic sex steroids, endometrial ablation, hysteroscopic sterilization, fertility preservation in endometrial cancer, tranexamic acid and breast cancer, menorrhagia treatment and breast cancer, abnormal uterine bleeding and premenopausal breast cancer, levonorgestrel IUD and breast cancer, tamoxifen and gynecologic abnormalities, tamoxifen metabolism, hormones and breast cancer risk, contraception and breast cancer, pregnancy and breast cancer, and breast cancer and infertility treatment.