Combined oestrogen--progestin treatment of vaginal haemorrhage following gonadotrophin-releasing hormone agonist therapy of uterine myomas

Three pre-menopausal women with uterine myomas were treatedwith leuprolide acetate depot and experienced profuse vaginalbleeding 7–11 weeks after initiation of treatment, despiteprofound oestradiol suppression. In each case, leuprolide therapywas discontinued and the women were treated with combinationoral contraceptives and ferrous sulphate. Vaginal bleeding ceasedwithin 24–48 h of oral contraceptive treatment in allwomen. Haemoglobin concentrations were restored to normal valuesand all women underwent definitive surgical treatments after4–6 weeks of oral contraceptive treatment without theneed for homologous blood transfusion. The final pathology reportrevealed focal necrosis of submucous myomas in all cases.