Comparison of the efficacy of estradiol dydrogesterone versus drospirenone ethinylestradiol for endometrial repair after abortion
TIAN Liang
WANG Xuelian
XIONG Yanmin
ZHAO Jia
Abstract：Objective To compare the effects of the estradiol and dydrogesterone regimen and the drospirenone and ethinylestradiol regimen on promoting endometrial repair after induced abortion.Methods A total of 152 patients who under-went induced abortion at the Second Affiliated Hospital of Henan University of Science and Technology from March 2023 to April 2025 were retrospectively analyzed.According to the different endometrial repair methods after operation,patients were di-vided into the combined group(n=77)and the COC group(n=75).The combination group received oral estradiol and dydroges-terone tablets,commencing on the first day after surgery and continuing for 3 months.The COC group received oral drospirenone and ethinylestradiol tablets,starting on the first day after surgery.The tablets were taken daily for 21 days,followed by a 7-day tablet-free interval.The next cycle was initiated after the onset of menstruation,and this regimen was repeated for a total of 3 cycles.The postoperative vaginal bleeding(duration and volume),menstrual recovery(time to first menstruation,amount of first menstrual flow,and regularity of menstrual cycle recovery),endometrial thickness at different time points,quality of life,and the incidence of complications within 3 months after surgery were compared.Results The endometrial thickness in the combined group at 14 days postoperatively and on days 2-3 after the first postoperative menstrual cycle((5.70±0.52)mm and(6.32±1.45)mm,respectively)were greater than those in the COC group((4.83±0.49)mm and(5.17±1.23)mm,respectively),and the differences were statistically significant(t=5.266,10.610,both P＜0.001).The duration of vaginal bleeding and the volume of vaginal bleeding in the combined group((30.17±2.72)mL and(6.35±0.94)days,respectively)were lower than those in the COC group((39.42±3.54)mL and(7.98±1.03)days,respectively),and the differences were statistically significant(t=10.196,18.093,both P＜0.001).The time to first postoperative menstruation in the combined group((26.13±2.25)days)was shorter than that in the COC group((32.84±2.96)days),and the difference was statistically significant(t=15.760,P＜0.001).The proportions of pa-tients with normal first postoperative menstrual flow and regular menstrual cycle recovery in the combined group were 75.32％(58/77)and 96.10％(74/77),respectively,higher than those in the COC group(44.00％(33/75)and 84.00％(63/75),respectively).The proportions of patients with hypomenorrhea and menorrhagia in the combined group were 18.18％(14/77)and 6.49％(5/77),respectively,lower than those in the COC group(33.33％(25/75)and 22.67％(17/75))(x2=16.492,6.258,both P＜0.05).After treatment,the 36-item short-form health survey score in the combined group((90.13±3.62)points)was significantly higher than that in the COC group((81.46±4.07)points)(t=13.886,P＜0.001).The incidence of complications within 3 months postoperatively did not differ significantly between the COC group and the combined group(9.33％(7/75)vs 6.49％(5/77),x2=0.421,P=0.516).Conclusion Compared with the drospirenone and ethinylestradiol regimen,the estradiol and dydrogesterone regimen is more ef-fective in promoting endometrial thickness recovery,shortening vaginal bleeding time,and optimizing menstrual cycle recovery af-ter induced abortion.However,the short-term complication rates of the two regimens were comparable,suggesting that continuous combination therapy may serve as one of the preferred options for postoperative endometrial repair.
Keywords：artificial abortionestradiol and dydrogesterone tabletsdrospirenone and ethinylestradiol tabletsendome-trial repairendometrial thickness
Publication Date：2026-01-25
Online Publishing Date：2026-03-03(First online date of this platform, not the publication date of the document)
Pages：5( 92-96 )