Spotting: Drug Therapy

Therapy target

  • Treatment depending on the causative disorder.
  • Remedy the bleeding
  • Normalization of the cycle.

Therapy recommendations

  • Hormone therapy to normalize the menstrual cycle if contraception is desired (desire for contraception; estrogen/progestin combination preparations (single-phase preparations, step preparations), contraceptives).
  • Hormone therapy when there is a desire for normalization of the cycle.
    • Ovulation bleeding (mid-cycle bleeding); estrogen therapy from the 12th to the 16th day of the cycle.
    • Premenstrual bleeding (prelubrication) in corpus luteum insufficiency (luteal weakness; progestogen monopreparations, oral; e.g., chlormadinone, desogestrel, dienogest, from the 16th (18th) to 25th day of the cycle for three cycles; progesterone).
    • Premenstrual bleeding (pre-lubrication) with premature decline in estrogen secretion/estrogen release (estrogens from the 22nd to 26th day of the cycle).
    • Postmenstrual bleeding (post-lubrication) in estrogen deficiency (estrogens, from the 3rd to 6th (8th) day of the cycle).
    • Postmenstrual bleeding (Nachschmieren) in prolonged rejection of the endometrium (endometrium) due to delayed fall of the corpus luteum (corpus luteum hormone; estrogen / progestogen combination preparations for contraception, 21st to 25th day of the cycle → acceleration of endometrial rejection / endometrial rejection by hormone withdrawal bleeding).