Therapeutic Amenorrhea in Hematologic Disorders

Abstract

Many hematologic disorders are accompanied by coagulation defects which, in women of childbearing age, can lead to severe menorrhagia. We have found it desirable and possible to render and maintain such patients amenorrheic. Twenty-nine patients were treated by one of three drug regimens: A = norethynodrel + mestranol, B = depo-medroxyprogesterone acetate, and C = depo-medroxyprogesterone acetate + conjugated estrogens. Acute leukemia and immune thrombocytopenic purpura were the most frequent diagnoses. Significant breakthrough bleeding occurred in 7 women (24%). Two were in group A (22%), 3 in B (38%), and 2 in C (17%). Although not statistically significant, these differences suggest that concurrent administration of estrogen and progestin is attended by less breakthrough bleeding than the administration of progestin alone.