Heavy menstrual bleeding
| Heavy menstrual bleeding | |
|---|---|
| Other names | Hypermenorrhea, menorrhagia |
| Specialty | Gynecology |
| Symptoms | bleeding more than usual |
| Complications | Anemia, severe pain |
| Risk factors | family history, anovulation, fibroids, polyps, and adenomyosis |
| Diagnostic method | based on physical examination |
| Differential diagnosis | Irregular menstruation |
| Medication | tranexamic acid |
Heavy menstrual bleeding (HMB), previously known as menorrhagia or hematomunia, is a menstrual period with excessively heavy flow. It is a type of abnormal uterine bleeding (AUB).[1][2]
Abnormal uterine bleeding can be caused by structural abnormalities in the reproductive tract, skipping ovulation (anovulation), bleeding disorders, hormonal issues (such as hypothyroidism) or cancer of the reproductive tract.[3]
Initial evaluation during diagnosis aims at determining pregnancy status, menopausal status, and the source of bleeding. One definition for diagnosing the condition is bleeding lasting more than 7 days or the loss of more than 80 mL of blood.[3]
Treatment depends on the cause, severity, and interference with quality of life.[4] Initial treatments often involve birth control pills, tranexamic acid, danazol and hormonal intrauterine device. Painkillers (NSAIDs) are also helpful.[5] Surgery can be effective for those whose symptoms are not well-controlled with other treatments.[6] Approximately 53 in 1000 women are affected by AUB.[7]
- ^ Cite error: The named reference
Munro 3–13was invoked but never defined (see the help page). - ^ Bacon JL (June 2017). "Abnormal Uterine Bleeding: Current Classification and Clinical Management". Obstetrics and Gynecology Clinics of North America. 44 (2): 179–193. doi:10.1016/j.ogc.2017.02.012. PMID 28499529.
- ^ a b O'Brien SH (2018). "Evaluation and management of heavy menstrual bleeding in adolescents: the role of the hematologist". Hematology. 30 (1): 390–398. doi:10.1182/asheducation-2018.1.390. PMC 6246024. PMID 30504337.
- ^ Committee on Practice Bulletins—Gynecology (July 2013). "Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction". Obstetrics and Gynecology. 122 (1): 176–85. doi:10.1097/01.AOG.0000431815.52679.bb. PMID 23787936. S2CID 2796244.
- ^ Cite error: The named reference
BofillRodriguez_2019was invoked but never defined (see the help page). - ^ Marjoribanks J, Lethaby A, Farquhar C (January 2016). "Surgery versus medical therapy for heavy menstrual bleeding". The Cochrane Database of Systematic Reviews. 2016 (1): CD003855. doi:10.1002/14651858.CD003855.pub3. PMC 7104515. PMID 26820670.
- ^ Kjerulff KH, Erickson BA, Langenberg PW (February 1996). "Chronic gynecological conditions reported by US women: findings from the National Health Interview Survey, 1984 to 1992". American Journal of Public Health. 86 (2): 195–9. doi:10.2105/ajph.86.2.195. PMC 1380327. PMID 8633735.