Anovulatory cycle In other cases, menstruation may be fairly regular (eumenorrhea), or more frequent (intervals < 21 days), or there may be a loss of menstrual pattern (menorrhagia, dysfunctional uterine bleeding). Normal menstrual bleeding in the ovulatory cycle is a result of a decline in progesterone due to the demise of the corpus luteum. It is thus a progesterone withdrawal bleeding. As there is no progesterone in the anovulatory cycle, bleeding is caused by the inability of estrogen — that needs to be present to stimulate the endometrium in the first place — to support a growing endometrium. Anovulatory bleeding is hence
Topical progesterone of tissue exposure to progesterone with this route of administration. These findings provide a possible explanation for how some studies found antiproliferative and atrophic changes in the endometrium with topical progesterone. However, elevated levels of progesterone in the endometrium with topical progesterone have not yet been demonstrated. Concern has been raised regarding topical progesterone in that the effects of such supraphysiological levels of progesterone in tissues are unknown and hence the potential for harmful effects has not been ruled out. Salivary monitoring of progesterone levels in women using topical progesterone and adjustment of dosage as necessary has been suggested as