Why does vaginal bleeding occur after the use of triptorelin acetate?

Patient's question:

Six months ago, I suddenly experienced severe pain in my lower abdomen, which was unbearable. Then I went to the hospital for a thorough examination, and the result was endometriosis. The doctor prescribed me triptorelin acetate, and after receiving the sixth injection, I started bleeding from my vagina 20 days later. The bleeding wasn't much, and I also had abdominal bloating and pain. Why did I bleed from my vagina 20 days after receiving the fifth injection of triptorelin acetate?

Doctor's answer:

Trupipride acetate is an androgen that can treat dysmenorrhea caused by endometriosis. Advice: Vaginal bleeding is now believed to be normal menstrual bleeding and can persist for 6 months to achieve the effect. However, considering you are only 32 years old, and the side effects of this medication are relatively significant, which may lead to weight gain, decreased libido, and other side effects, as well as early aging, it is recommended that you do not use this medication and instead opt for laparoscopy.

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