After having a cesarean delivery, a woman may experience vaginal bleeding outside her normal periods. Taking oral contraceptive pills can resolve the problem, researchers in Japan report.
Anatomic defects at the site of cesarean section scars in the uterus are thought to be the cause of such bleeding, they explain. However, there is currently no simple treatment.
Dr. Masahiro Tahara from Osaka University Graduate School of Medicine and colleagues evaluated the effectiveness of treatment with an oral contraceptive containing a combination of estrogen and progesterone (Pranoval) in 11 women with recurrent vaginal bleeding after a c-section.
Ten of the women had a decrease and then cessation of bleeding after three treatment cycles, the team reports in the medical journal Fertility and Sterility, and the eleventh woman became free of abnormal vaginal bleeding after an additional three cycles.
The investigators are uncertain about how the treatment works, but proposed mechanisms include an effect on coagulation and improvement in the integrity of the lining of blood vessels.
“Our findings support the use of conservative hormonal therapy for treating intermenstrual bleeding in patients with defects at the previous cesarean uterine scar,” the authors conclude. “However, it must be noted that this study is preliminary, and more work is needed to show the effectiveness in a large population of women with prior cesarean deliveries.”
SOURCE: Fertility and Sterility, August 2006.
Revision date: June 21, 2011
Last revised: by Jorge P. Ribeiro, MD