Template:Non pregnant vaginal bleeding treatment - Revision history

Rossdonaldson1 at 22:30, 26 February 2025

2025-02-26T22:30:39Z

← Revisión anterior		Revisión del 22:30 26 feb 2025
Línea 1:		Línea 1:
	''If you are concerned for malignancy, hormonal therapy should be avoided ~~until patient can be evaluated by~~ OBGYN ~~for possible biopsy~~, ~~since~~ these medications may interfere with ~~those~~ results.''		''If you are concerned for malignancy, hormonal therapy should be avoided unless discussed with OBGYN, as these medications may interfere with possible biopsy results.''
	===Mild Bleeding===		===Mild Bleeding===
	*[[Iron supplementation]]		*[[Iron supplementation]]

Rossdonaldson1 at 22:29, 26 February 2025

2025-02-26T22:29:25Z

← Revisión anterior		Revisión del 22:29 26 feb 2025
Línea 1:		Línea 1:
	''If you are concerned for malignancy, hormonal therapy should be avoided until patient can be evaluated by OBGYN for possible biopsy, since these medications ~~can~~ interfere with those results.''		''If you are concerned for malignancy, hormonal therapy should be avoided until patient can be evaluated by OBGYN for possible biopsy, since these medications may interfere with those results.''
	===Mild Bleeding===		===Mild Bleeding===
	*[[Iron supplementation]]		*[[Iron supplementation]]

Rossdonaldson1 at 22:29, 26 February 2025

2025-02-26T22:29:10Z

← Revisión anterior		Revisión del 22:29 26 feb 2025
Línea 1:		Línea 1:
			''If you are concerned for malignancy, hormonal therapy should be avoided until patient can be evaluated by OBGYN for possible biopsy, since these medications can interfere with those results.''
	===Mild Bleeding===		===Mild Bleeding===
	*[[Iron supplementation]]		*[[Iron supplementation]]
Línea 34:		Línea 35:
	** History of breast cancer		** History of breast cancer
	** Liver disease		** Liver disease
	~~<br>~~

	~~If you are concerned for malignancy, hormonal therapy should be avoided until patient can be evaluated by OBGYN for possible biopsy, since these medications can interfere with those results.~~

	===Life Threatening===		===Life Threatening===

Rossdonaldson1: /* Pharmacologic Treatment Regimens For Acute Abnormal Uterine Bleeding American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 557: management of acute abnormal uterine bleeding in nonpregnant reproductiveaged women. Obstet Gynecol. 2013;121(4):891-896 Tibbles CD. Selected gynecologic disorders: abnormal uterine bleeding in the nonpregnant patient. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. Philadelphia, PA:...

2024-01-24T20:43:49Z

/* Pharmacologic Treatment Regimens For Acute Abnormal Uterine Bleeding American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 557: management of acute abnormal uterine bleeding in nonpregnant reproductiveaged women. Obstet Gynecol. 2013;121(4):891-896 Tibbles CD. Selected gynecologic disorders: abnormal uterine bleeding in the nonpregnant patient. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. Philadelphia, PA:...

← Revisión anterior		Revisión del 20:43 24 ene 2024
Línea 59:		Línea 59:
	\| Combination oral contraceptive pills \|\|1 pill TID PO for 7 days or 1 pill bid PO for 5 days, then 1 pill daily until pack is finished\|\| > 35 y who smoke, history of DVT or PE, breast cancer, liver disease, known thromboembolic disorders, pregnancy, ischemic heart disease, cerebrovascular disease, or uncontrolled hypertension		\| Combination oral contraceptive pills \|\|1 pill TID PO for 7 days or 1 pill bid PO for 5 days, then 1 pill daily until pack is finished\|\| > 35 y who smoke, history of DVT or PE, breast cancer, liver disease, known thromboembolic disorders, pregnancy, ischemic heart disease, cerebrovascular disease, or uncontrolled hypertension
	\|-		\|-
	\| Progestin-only oral contraceptive pills (medroxyprogesterone acetate)\|\|20 mg TID PO for 7 days or 10 mg daily PO for 10 days\|\|Active or past DVT or PE, liver disease, or breast cancer		\| Progestin-only oral contraceptive pills ([[medroxyprogesterone]] acetate)\|\|20 mg TID PO for 7 days or 10 mg daily PO for 10 days\|\|Active or past DVT or PE, liver disease, or breast cancer
	\|-		\|-
	\| [[NSAIDs]]: [[Ibuprofen]]\|\|200-400 mg 3-4 times/day PO for 5 days\|\|Advanced renal disease		\| [[NSAIDs]]: [[Ibuprofen]]\|\|200-400 mg 3-4 times/day PO for 5 days\|\|Advanced renal disease

Rossdonaldson1: /* Pharmacologic Treatment Regimens For Acute Abnormal Uterine Bleeding American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 557: management of acute abnormal uterine bleeding in nonpregnant reproductiveaged women. Obstet Gynecol. 2013;121(4):891-896 Tibbles CD. Selected gynecologic disorders: abnormal uterine bleeding in the nonpregnant patient. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. Philadelphia, PA:...

2024-01-24T20:42:59Z

← Revisión anterior		Revisión del 20:42 24 ene 2024
Línea 57:		Línea 57:
	\| Conjugated equine estrogen\|\|25 mg IV every 4-6 h until bleeding stops, up to 24 h\|\|Active or past thromboembolic disease, breast cancer, or liver disease		\| Conjugated equine estrogen\|\|25 mg IV every 4-6 h until bleeding stops, up to 24 h\|\|Active or past thromboembolic disease, breast cancer, or liver disease
	\|-		\|-
	\| Combination oral contraceptive pills \|\|1 pill ~~tid~~ PO for 7 days or 1 pill bid PO for 5 days, then 1 pill qd until pack is finished\|\| > 35 y who smoke, hx of DVT or PE, breast cancer, liver disease, known thromboembolic disorders, pregnancy, ischemic heart disease, cerebrovascular disease, or uncontrolled hypertension		\| Combination oral contraceptive pills \|\|1 pill TID PO for 7 days or 1 pill bid PO for 5 days, then 1 pill daily until pack is finished\|\| > 35 y who smoke, history of DVT or PE, breast cancer, liver disease, known thromboembolic disorders, pregnancy, ischemic heart disease, cerebrovascular disease, or uncontrolled hypertension
	\|-		\|-
	\| Progestin-only oral contraceptive pills (medroxyprogesterone acetate)\|\|20 mg ~~tid~~ PO for 7 days or 10 mg qd PO for 10 days\|\|Active or past DVT or PE, liver disease, or breast cancer		\| Progestin-only oral contraceptive pills (medroxyprogesterone acetate)\|\|20 mg TID PO for 7 days or 10 mg daily PO for 10 days\|\|Active or past DVT or PE, liver disease, or breast cancer
	\|-		\|-
	\| NSAIDs: Ibuprofen\|\|200-400 mg 3-4 times/day PO for 5 days\|\|Advanced renal disease		\| [[NSAIDs]]: [[Ibuprofen]]\|\|200-400 mg 3-4 times/day PO for 5 days\|\|Advanced renal disease
	\|-		\|-
	\| Antifibrinolytic agents (tranexamic acid) \|\|1.3 g ~~tid~~ PO for up to 5 days\|\|Active intravascular clotting or subarachnoid hemorrhage		\| Antifibrinolytic agents ([[tranexamic acid]]) \|\|1.3 g TID PO for up to 5 days\|\|Active intravascular clotting or subarachnoid hemorrhage
	\|}		\|}

Rossdonaldson1: /* Moderate continued bleeding */

2024-01-24T20:41:38Z

Moderate continued bleeding

← Revisión anterior		Revisión del 20:41 24 ene 2024
Línea 31:		Línea 31:
	*Contraindications		*Contraindications
	** History of [[VTE]]		** History of [[VTE]]
	** History of arterial [[thromboembolic events]]		** History of arterial thromboembolic events
	** History of breast cancer		** History of breast cancer
	** [[Liver disease]]		** Liver disease
	<br>		<br>

Rossdonaldson1: /* Moderate continued bleeding */

2024-01-24T20:41:16Z

Moderate continued bleeding

← Revisión anterior		Revisión del 20:41 24 ene 2024
Línea 7:		Línea 7:

	===Moderate continued bleeding===		===Moderate continued bleeding===
	Patients may benefit from initiation of short or long-term birth control for acute cessation.		''Patients may benefit from initiation of short or long-term birth control for acute cessation.''

	'''Combined OCPs'''		'''Combined OCPs'''

Rossdonaldson1: /* Moderate continued bleeding */

2024-01-24T20:38:09Z

Moderate continued bleeding

← Revisión anterior		Revisión del 20:38 24 ene 2024
Línea 14:		Línea 14:
	*Contraindications		*Contraindications
	** Cigarette smoking if older than 34 years		** Cigarette smoking if older than 34 years
	** ~~HTN~~		** [[Hypertension]]
	** Hx of VTE		** History of [[VTE]]
	** Cerebrovascular disease		** Cerebrovascular disease
	** CAD or valvular disease		** CAD or valvular disease
	** Hx of breast cancer		** History of breast cancer
	** Diabetes with vascular involvement		** [[Diabetes]] with vascular involvement
	** Surgery with immobilization		** Surgery with immobilization
	** Liver cirrhosis		** Liver [[cirrhosis]]
	** Other pro-coagulative ~~coditions~~ (e.g. Lupus, Factor V Leiden)		** Other pro-coagulative conditions (e.g. [[Lupus]], [[Factor V Leiden]])

	'''Medroxyprogesterone'''		'''[[Medroxyprogesterone]]'''
	*'''20 mg PO TID for 7 days'''<ref name="ACOG" />		*'''20 mg PO TID for 7 days'''<ref name="ACOG" />
	**76% success, median time 3 days		**76% success, median time 3 days
Línea 30:		Línea 30:
	**In a trial of 48 patients all had cessation in 5 days.<ref name="highdose">Ammerman SR, Nelson AL. A new progestogen-only medical therapy for outpatient management of acute, abnormal uterine bleeding: a pilot study. Am J Obstet Gynecol. 2013. 208(6):499.e1-e5.</ref>		**In a trial of 48 patients all had cessation in 5 days.<ref name="highdose">Ammerman SR, Nelson AL. A new progestogen-only medical therapy for outpatient management of acute, abnormal uterine bleeding: a pilot study. Am J Obstet Gynecol. 2013. 208(6):499.e1-e5.</ref>
	*Contraindications		*Contraindications
	** Hx of VTE		** History of [[VTE]]
	** Hx of ~~aterial~~ thromboembolic events		** History of arterial [[thromboembolic events]]
	** Hx of breast cancer		** History of breast cancer
	** Liver disease		** [[Liver disease]]
	<br>		<br>

Rossdonaldson1 at 20:36, 24 January 2024

2024-01-24T20:36:15Z

← Revisión anterior		Revisión del 20:36 24 ene 2024
Línea 3:		Línea 3:
	**324mg ferrous sulfate tablet PO TID (each tab contains 65mg of elemental iron)		**324mg ferrous sulfate tablet PO TID (each tab contains 65mg of elemental iron)
	*[[NSAIDs]]		*[[NSAIDs]]
	**e.g. ibuprofen 400 mg PO q6h, or naproxen 500 mg PO BID		**e.g. [[ibuprofen]] 400 mg PO q6h, or [[naproxen]] 500 mg PO BID
	**For cramping pain and can decreases intra-uterine bleeding. Reduces endometrial prostaglandin levels and promotes vasoconstriction in the uterus		**For cramping pain and can decreases intra-uterine bleeding. Reduces endometrial prostaglandin levels and promotes vasoconstriction in the uterus

Urinetrouble: /* Mild Bleeding */

2024-01-10T21:00:56Z

Mild Bleeding

← Revisión anterior		Revisión del 21:00 10 ene 2024
Línea 2:		Línea 2:
	*[[Iron supplementation]]		*[[Iron supplementation]]
	**324mg ferrous sulfate tablet PO TID (each tab contains 65mg of elemental iron)		**324mg ferrous sulfate tablet PO TID (each tab contains 65mg of elemental iron)
	*[[~~Ibuprofen~~]]		*[[NSAIDs]]
	**For ~~cramps~~ and can ~~theoretically~~ decreases intra-uterine bleeding		**e.g. ibuprofen 400 mg PO q6h, or naproxen 500 mg PO BID
	**Reduces endometrial prostaglandin levels and promotes vasoconstriction in the uterus		**For cramping pain and can decreases intra-uterine bleeding. Reduces endometrial prostaglandin levels and promotes vasoconstriction in the uterus

	===Moderate continued bleeding===		===Moderate continued bleeding===