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
Pharmacokinetics of progesterone 800 mg/day vaginal progesterone (about 70 ng/mL and 12 ng/mL, respectively), although local progesterone levels in the uterus were 10 times higher with the vaginal route due to a uterine first-pass effect (around 1.5 ng/mL and almost 12 ng/mL, respectively). The duration of progesterone is extended by the intramuscular route due to a depot effect in which it is stored locally in adipose tissue, and can be administered once every 1 to 3 days. The half-life of intramuscular progesterone is significantly longer when it is injected into the gluteal muscles of the buttocks rather than the deltoid muscle of the