Gynecological Medications: Effects and Concerns for Women - Pharmacology

Dr. Zhuo Wenhui reply Pharmacology

---

1.
CHUSELIN CAPSULES 250MG (TRANEXAMIC ACID) "Y.S.": Hemostatic capsules for systemic and local bleeding or hemorrhagic disorders.

2.
WECON-II CHEWABLE TABLETS "YU SHENG": Chewable tablets for relieving gastric discomfort, heartburn, excessive gastric acid, and indigestion.

3.
MAGNESIUM OXIDE: Used to relieve gastric discomfort or heartburn, or for diagnosed conditions such as gastric and duodenal ulcers, gastritis, and esophagitis associated with excessive gastric acid.

4.
HETEL CAPSULES (CLOMIPHENE) "M.T.": Capsules for promoting ovulation, regulating menstrual cycles, and treating female infertility.

Abnormal uterine bleeding generally refers to irregular bleeding patterns in women with normally regular menstrual cycles.
Bleeding outside of the menstrual period or post-menopause is considered abnormal and should not be ignored, as it may indicate conditions ranging from benign cervical lesions to severe cervical cancer.

Abnormal uterine bleeding can be classified into two main categories: organic and functional.
Organic bleeding is caused by pathological changes in the female reproductive organs, primarily characterized by irregular and unpredictable bleeding.
This type of bleeding typically does not affect ovarian function, allowing for regular menstrual cycles alongside abnormal bleeding.
Functional bleeding, on the other hand, arises from anovulation or hormonal imbalances, leading to irregular menstrual cycles or prolonged menstruation.
This type of bleeding is not directly related to inflammation, tumors, or pregnancy.

Causes of organic uterine bleeding include:
1.
Cervical cancer: The most critical and life-threatening cause of uterine bleeding.
Initial bleeding may occur between menstrual cycles or after intercourse, often presenting as light spotting.
Medical evaluation is essential, as this bleeding can resemble cervical erosion or polyps.
A Pap smear and further pathological examination are necessary for early detection.
If diagnosed with cancer, treatment may involve radiation therapy or radical hysterectomy.

2.
Cervical polyps: Bleeding from cervical polyps is usually minimal and occurs between menstrual periods, particularly after bowel movements or intercourse.
Some polyps may be asymptomatic and discovered during routine examinations.
Early diagnosis is crucial to prevent delays in treatment, which typically involves polypectomy.

3.
Cervical erosion or eversion: Many women experience cervical erosion or eversion, where the affected mucosa appears red, congested, or granular, leading to easy bleeding.
Severe congestion may necessitate evaluation for cervical cancer through cytology and pathology.
If cancer is ruled out, treatment may involve cauterization or cryotherapy.

4.
Endometrial cancer: This is a common cause of abnormal uterine bleeding, especially in postmenopausal women.
It can also occur in reproductive-age women, accounting for about a quarter of cases.
Initial bleeding may be light and gradually increase.
If endometrial cancer is suspected, an endometrial biopsy is required, followed by hysterectomy if confirmed.

5.
Uterine fibroids: These can also cause significant bleeding.
Fibroids can be classified as submucosal, intramural, or subserosal, with submucosal fibroids being the most likely to cause bleeding.
Women with fibroids should not automatically attribute abnormal bleeding to them without investigating other potential causes.

6.
Ovarian tumors: Any ovarian tumor can potentially cause uterine bleeding, particularly those producing female hormones, such as granulosa cell tumors.
Non-hormone-producing tumors, whether benign or malignant, are less likely to cause bleeding.
Surgical removal of the tumor is necessary upon discovery.

Functional uterine bleeding refers to bleeding without identifiable lesions in the uterus, fallopian tubes, or ovaries, often due to temporary endocrine imbalances leading to abnormal hormone secretion and endometrial bleeding.
Most cases are anovulatory, although some patients may still ovulate.
Functional bleeding tends to be more profuse and prolonged, often resulting in extended menstrual periods or intermittent bleeding.

Adolescents and perimenopausal women are particularly susceptible, but it can occur in women of reproductive age as well.
Young girls may experience irregular cycles shortly after menarche due to immature ovarian function, leading to prolonged or missed periods.
Chronic bleeding can result in anemia and weakness, and may sometimes be severe enough to require treatment.
Blood tests are essential to rule out hematological disorders, such as leukemia or thrombocytopenia, which may only become apparent during significant bleeding episodes.

For women who have been pregnant or given birth, endometrial curettage (dilation and curettage) is a meaningful treatment for functional uterine bleeding, as it often resolves the bleeding.
The curettage specimen should be sent for pathological examination to identify any overlooked lesions and assess hormonal status, which is crucial for future preventive treatment.

Hormonal therapy can be effective when administered systematically, but discontinuing treatment prematurely can lead to recurrent bleeding and associated symptoms, a situation referred to as "medically induced bleeding." This occurs due to improper use of hormones without a structured plan.
Therefore, if hormonal treatment is indicated, it is essential for the physician to provide a clear plan and for the patient to cooperate to avoid worse outcomes than untreated conditions.
Women on oral contraceptives may also experience similar bleeding due to inconsistent use.

---

Reply Date: 2007/05/29