Abstract:

Intrauterine adhesions can cause a series of symptoms such as amenorrhea, secondary infertility and recurrent abortion in women. There is still a high recurrence rate after hysteroscopic transcervical resection of adhesions, which seriously affects women′s fertility and mental health. Estrogen adjuvant therapy can effectively reduce the recurrence rate after transcervical resection of adhesions by promoting the repair of residual endometrial hyperplasia and reducing the expression of endometrial fibrosis factors, but a unified medication regimen has not yet been formed. The commonly used clinical regimen is estradiol valerate tablets 2-4 mg/d or equivalent hormone plus progesterone sequential oral administration for 2-3 menstrual cycles. The efficacy of high-dose estrogen therapy is still not very clear, or individualized estrogen therapy can be formulated by detecting the expression level of estrogen receptor in the endometrium to achieve the best efficacy. Oral estrogen is the most classic treatment for intrauterine adhesions. However, recent studies have shown that transdermal and transvaginal administration of estrogen have higher bioavailability, fewer adverse reactions, and comparable efficacy. At present, there are still significant variation in the usage and dosage of estrogen in a large number of clinical studies. Therefore, more large-scale and high-quality studies are still needed to explore the best medication regimen of estrogen.

Key words: Estrogens, Intrauterine adhesion, Endometrium, Transcervical resection of adhesions, Therapy