Norplant (R) users with irregular bleeding - Ultrasonographic assessment and evaluation of serum concentrations of estradiol and progesterone

OBJECTIVE: To determine the changes in thickness and pattern of endometrium among Norplant(R) (Leiras, Leiras Oy, Turku, Finland) users who have irreg ular bleeding and to correlate these changes with estradiol and progesteron e concentrations. STUDY DESIGN: Ultra-sonographic evaluation (vaginal ultrasound) and serum s ampling were performed on Norplant(R) users who presented with complaints o f bleeding at their First visit to the Family Planning Clinic, Department o f Obstetrics and Gynecology, Chulalongkong Hospital, Bangkok, Thailand, bet ween October 1, 1998, and March 31, 1999. RESULTS: A fetal of 85%(44/52 cases) of the subjects had estradiol concentr ations < 50 pg/mL, and none had any luteal activity (progesterone concentra tion <3 ng/mL). The endometrial thickness remained thin and very thin (3-6 mm =50%, <3 mm = 48%). A hyperechoic pattern in the endometrium was found i n 90% of the subjects. There was a weak, negative correlation between estra diol concentration and endometrial thickness (P < .05, r = -.337). CONCLUSION Norplant(R) users with irregular bleeding were usually character ized by low estradiol concentrations, absence of luteal activity and a thin , hyperechoic pattern in the endometrium.