Abnormal uterine bleeding in women of reproductive age and premenopause

Abnormal uterine bleeding (AUB) occurs in 3–30% of women and its prevalence depends on the living standards of a patient and the state of health care in different countries. This is most common in women with obesity, polycystic ovary syndrome, in premature ovarian failure and during premenopause. The review describes the efficacy of medicines, the frequency of complications (for example, the risk of venous thromboembolism when taking combined oral contraceptives, depending on the type of progestogen), and contraindications. Progestogens are widely used for the treatment of AUB since they neutralize progesterone deficiency and anovulation and have anti-inflammatory effects. In Russia, dydrogesterone is a progestogen with registered indications, such as irregular menstruation, dysfunctional uterine bleeding, endometriosis, secondary amenorrhea, premenstrual syndrome, and hormone replacement therapy. Conclusion. Dydrogesterone therapy has been shown to be significantly effective in normalizing irregular menstrual cycles, including this in randomized controlled trials. Considering that dydrogesterone is a metabolically neutral drug; it lacks androgenic, glucocorticoid, mineralocorticoid, and antigonadotropic effects; it does not aggravate insulin resistance and dyslipidemic disorders or affect the hemostatic system; it can be recommended for a wide population of women with AUB. © A group of authors, 2020.