Dysfunctional uterine bleeding is a major gynecologic problem, with varied treatment options. A significant proportion of these patients undergo hysterectomy. To investigate the hormonal milieu at tissue level, we semiquantitatively assessed the estrogen and progesterone receptors in the endometrial samples of 50 DUB patients, by Immunohistochemistry.
We observed a significant increase (p<0.001) in the concentration of both estrogen and progesterone receptors in patients with dysfunctional uterine bleeding, compared to normal population. We also noted a significant increase in the endometrial thickness (p<0.001) of patients with simple endometrial hyperplasia.
Our study demonstrates the role of estrogen and progesterone receptors in the etiopathogenesis of dysfunctional uterine bleeding and in the alteration in the morphology of endometrium, such as simple endometrial hyperplasia. We advocate the use of progesterone antagonists and selective progesterone receptor modulators in the treatment of patients with dysfunctional uterine bleeding, especially in those with endometrial hyperplasia, who carry the long term risk of endometrial carcinoma with sustained endometrial estrogenic stimulation.
Shanthala S and Subramanya H