For acute Abnormal Uterine Bleeding (AUB), what is the only FDA-approved medical management option?

The only FDA-approved medical management option for acute abnormal uterine bleeding (AUB) is the administration of intravenous (IV) estrogen. This treatment is particularly effective in situations where there is heavy bleeding due to conditions like dysfunctional uterine bleeding or during perimenopause. IV estrogen works by promoting endometrial stabilization, which helps to control and stop the bleeding more rapidly than other methods.

In the context of AUB, IV estrogen can be especially critical in settings where patients may present with significant volume depletion or hemodynamic instability due to acute blood loss, making it a vital option for urgent intervention. Other treatment methods, while beneficial in managing AUB in various contexts, do not hold FDA approval specifically for this acute scenario. For instance, oral contraceptives and progestins are often used for the long-term management of menstrual disorders but are not the go-to options in acute bleeding situations. Intravaginal estradiol is typically not used for acute bleeding either; instead, it is more relevant for vaginal atrophy and menopausal symptoms. Therefore, IV estrogen stands out as the approved and recommended treatment in acute episodes of abnormal uterine bleeding.