THE EFFECT OF INTRAVENOUS ESTROGEN IN UTERINE BLEEDING*

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Abstract
Sixty cases of acute uterine bleeding were treated by intravenous admn. of an aqueous soln. containing Premarin (Conjugated Natural Estrogens-equine). The usual dosage was 5 cc. (20 mg. of sodium estrone sulfate equivalent)every 6-12 hours for a total of 3 or 4 doses. The response to intravenous estrogen therapy was observed in menorrhagia associated with various conditions, including functional uterine bleeding associated with cystic glandular hyperplasia of the endometrium, acyclic and imperfect progestational endometrium, uterine fibromyomas, estrogen-withdrawal bleeding, progesterone-withdrawal bleeding (excessive, in presence of fibromyomas), endometriosis, endometrial polyp, Von Recklinghausen''s disease, menopausal menorrhagia, pelvic inflammatory disease; also from organic causes, including menorrhagia associated with postabortal subinvolution of the uterus, ectopic pregnancy, and adenocarcinoma of the body of the uterus. Satisfactory arrest of bleeding was noted in 48 of the 57 cases of functional uterine bleeding. In 5 others, the results were temporary and the overall result was inadequate. Great care should be exercised in the management of patients with uterine bleeding since apparently good, though temporary, results may be obtained in patients with endometrial carcinoma or ectopic pregnancy. After initial arrest of bleeding by admn. of estrogens intravenously, a regimen of oral estrogen therapy in diminishing doses followed by a course of cyclic progestin therapy was satisfactory in re-establishing the menstrual cycle. No untoward effects were encountered except for some nausea.

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