THE EFFECT OF INTRAVENOUS ESTROGEN IN UTERINE BLEEDING*

Abstract

ONLY in recent years has an understanding of the physiology of functional uterine bleeding afforded a rational approach to successful therapy. Not until twenty-three years ago, when Allen (1) postulated that menstruation was due to cyclic reduction of the amount of estrogenic hormone in the body, was a scientific approach to the therapy of menorrhagia unveiled. Five years later the application of this work to the physiology of menstruation was modified by the observation of Smith and Engle (2) that estrogen withdrawal bleeding does not occur if withdrawal of this steroid is followed by injections of progesterone. Since our present knowledge indicates that menstruation is directly under control of the steroid hormones of the ovary, it is logical to consider use of these same steroids to correct excessive uterine bleeding due to disorders of cyclic ovarian-endometrial function. The literature in the past decade has reflected extensive study of endocrine therapy for functional uterine bleeding; and judicious use of gonadal steroids has finally gained warranted prestige over radiation and radical surgical procedures in the treatment of this one of the most common of the endocrinopathies.