To investigate the clinical efficacy and safety of medroxyprogesterone acetate tablets in the treatment of ovulatory dysfunction-related abnormal uterine bleeding.

Patients with ovulatory dysfunction-related abnormal uterine bleeding were allocated into control group and treatment group based on their treatment regimen. The control group received dydrogesterone tablets (10 mg, twice daily) for 10 days starting from the 14th day of the menstrual cycle. The treatment group received medroxyprogesterone acetate tablets (2 mg, three times daily) for 10 days, also starting from the 14th day of the menstrual cycle. Both groups were treated for three menstrual cycles. The clinical efficacy, recovery indicators, angiogenesis and inflammatory response markers, and safety were compared between the two groups.

A total of 135 cases were included in the analysis, with 64 in the control group and 71 in the treatment group. The overall response rate of treatment group and control group were 88.73% (63 cases/71 cases) and 82.81% (53 cases/64 cases), respectively (P>0.05). After treatment, endometrial thickness of treatment group and control group were (6.78±1.23) and. (7.36±1.48) mm, respectively; menstrual blood loss were (60.83±9.78) and (64.61±9.25) mL, respectively; hemostasis time were (3.55±1.85) and (3.95±1.82) d, respectively; follicle stimulating hormone (FSH) levels were (6.07±0.96) and (6.51±1.05) U·L^-1, respectively; prolactin (PRL) levels were (8.92±1.37) and (9.65±1.49) μg·L^-1, respectively; progesterone (P) levels were (0.87±0.13) and (0.94±0.16) pg·mL^-1, respectively; matrix metalloproteinase 9 (MMP-9) levels were (22.16±3.58) and (23.93±3.71) pg·mL^-1, respectively; activator protein-1 (AP-1) levels were (36.82±4.76) and (39.57±5.37) pg·mL^-1, respectively; prostaglandin I2 (PGI₂) levels were (21.39±3.84) and (23.18±4.06) pg·mL^-1, respectively; angiotensin-Ⅱ (Ang-Ⅱ) levels were (164.47±22.58) and (175.81±35.94) pg·mL^-1, respectively; basic fibroblast growth factor (bFGF) levels were (21.15±3.42) and (19.63±3.08) pg·mL^-1, respectively. Except for hemostasis time, all the above indicators showed statistically significant differences between the two groups (all P<0.05). The incidence of adverse reactions in the treatment group and control group was 8.45% (6 cases/71 cases) and 12.50% (8 cases/64 cases), respectively, with no statistical significance (P>0.05).

Compared with dydrogesterone, medroxyprogesterone acetate tablets demonstrates comparable efficacy and safety in treating ovulatory dysfunction-related abnormal uterine bleeding. However, medroxyprogesterone acetate tablets shows superior effects in improving endometrial thickness, reducing menstrual blood loss, regulating sex hormone levels, modulating angiogenesis-related markers.