What is the most appropriate short-term treatment for severe abnormal uterine bleeding?

• A. Combination estrogen/progesterone
• B. Androgen therapy
• C. Gonadotropin-releasing hormone analogs
• D. Estrogen only

Answer: (D)

The most appropriate short-term treatment for severe abnormal uterine bleeding is estrogen only. This therapy effectively promotes the stabilization of the endometrial lining, which can help reduce heavy menstrual bleeding. Estrogen works by increasing the proliferation of the endometrial tissue and can also cause direct vasoconstriction of uterine blood vessels, thus reducing the volume of bleeding.

In acute situations of severe abnormal uterine bleeding, rapid control is needed, and estrogen therapy can provide that necessary intervention. The use of estrogen alone is particularly beneficial in scenarios such as anovulation, where there may be an underlying hormonal imbalance contributing to excessive bleeding.

Combination estrogen/progesterone options, while effective in long-term management and in stabilizing uterine bleeding patterns over time, are not as immediate in action for acute episodes. Androgen therapy is more suited for conditions related to hormonal imbalances like polycystic ovary syndrome (PCOS) rather than acute bleeding. Gonadotropin-releasing hormone analogs can help in managing certain conditions like endometriosis and fibroids but are more often used for chronic management rather than immediate relief in cases of acute abnormal bleeding.