Menstrual Suppression Therapy

Question 1

COCP limitations, amenorrhea and advantages

Answer 1

Limitations: BTB, hormonal side effects, risk of VTE
70% Amenorrhea at 1 year with continuous use
Advantages: long history and clinical experience with use

Question 2

Depot - dosing, limit, advantages, amen

Answer 2

150mg IM
Limits: BTB, progestin related side effects, weight gain, reversible impact on bone density with prolonged use (>2yrs)
50-60% amenorrhoeic at one teaser, 70% at two years
Advantage: 12 week administration

Question 3

POP-limit, amen, advantages

Answer 3

Limit: irregular bleeding, progestin related SE, adverse impact on lipids
Amen: up to 76% with high dose progestins at 2 years
Advantage: adjustable dosing compared to DMPA, useful if oestrogens contraindicated

Question 4

GnRH-a limit, amen, advantages

Answer 4

Limit: initial stimulators effect and bleeding prior to suppression, menopausal symptoms, impact on bone density with prolonged use
Amen: high rates
Adv: may provide ovarian protection from chemotoxic effects of chemotherapy

Question 5

Mirena - dose, limit, adv, amen

Answer 5

20micrograms per day
Initial BTB and possible hormonal SEs usually improve with time
50% at 1r, 60% at 5 years
Benefits for HMB, endo, adeno, fibroids (top tier contraceptive efficacy

Question 6

Danazol dose, limit, amen, adv

Answer 6

400-800mg daily
Limit: weight gain, androgenic SE, menopausal symptoms
High rates amen