Hormonal treatment of benign bleeding disorders in women during different periods of life

The hormonal treatment of dysfunctional uterine bleeding is most reasonable when the disorder is caused by a disturbed menstrual cycle. Thus, reproduc tive age is the domain of hormone therapy. Especially after menarche and in the premenopause,the hypothalamic-pituitary-gonadal axis shows unstable fu nction causing several forms of bleeding disorders. Disturbances of cyclic function by endocrine or metabolic factors and organic genital lesions must be considered and should be included in the therapeutic concept. First of all, hormonal therapy of bleeding disorder provides the direct eff ect of the drug on the endometrium. The interferences with superior regulat ing mechanisms are also part of the thera py; as, for instance, in the use of GnRH analogues. In this paper,we discuss several hormonal treatment modalities regarding di fferent clinical bleeding patterns. The limited applications of hormonal th erapy before and beyond the reproductive age are also mentioned.