COMBINED ESTROGEN PROGESTIN TREATMENT OF VAGINAL HEMORRHAGE FOLLOWINGGONADOTROPIN-RELEASING-HORMONE AGONIST THERAPY OF UTERINE MYOMAS

Three pre-menopausal women with uterine myomas were treated with leupr olide acetate depot and experienced profuse vaginal bleeding 7 - 11 we eks after initiation of treatment, despite profound oestradiol suppres sion. In each case, leuprolide therapy was discontinued and the women were treated with combination oral contraceptives and ferrous sulphate . Vaginal bleeding ceased within 24 - 48 h of oral contraceptive treat ment in all women. Haemoglobin concentrations were restored to normal values and all women underwent definitive surgical treatments after 4 - 6 weeks of oral contraceptive treatment without the need for homolog ous blood transfusion. The final pathology report revealed focal necro sis of submucous myomas in all cases.