The Medical and Surgical Practice of NaProTECHNOLOGY, 387-406, 2004
Chapter 32: Unusual Bleeding: Evaluation and Treatment
Author affiliations
- Pope Paul VI Institute for the Study of Human Reproduction, Omaha, Nebraska. ROR
Abstract
Unusual uterine bleeding -- including premenstrual spotting, tail-end brown bleeding, mid-cycle intermenstrual bleeding, and heavy menses -- is evaluated in NaProTECHNOLOGY through prospective CrMS charting combined with cycle-phase-targeted estradiol and serial post-Peak progesterone profiles, which typically reveal luteal phase deficiency, follicular estradiol insufficiency, or anovulation as the primary etiology. Treatment is etiology-directed and cycle-synchronized: cooperative progesterone replacement for luteal defects, follicular support or ovulation induction for follicular phase insufficiency, and fertility-sparing surgical correction for structural pathology such as endometriosis, polyps, or fibroids, without routine recourse to contraceptive suppression.
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Cite this article
Hilgers, T. W. (2004). Chapter 32: Unusual Bleeding: Evaluation and Treatment. *The Medical and Surgical Practice of NaProTECHNOLOGY*, 387-406.
Hilgers TW. Chapter 32: Unusual Bleeding: Evaluation and Treatment. The Medical and Surgical Practice of NaProTECHNOLOGY. 2004:387-406.