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One-third of women will experience abnormal uterine bleeding in their life. Normal menstrual cycle has a frequency of 24 to 38 days, lasts 7 to 9 days, so bleeding that lasts longer could be considered abnormal. Very heavy bleeding (for example, needing to use 1 or more tampons or sanitary pads every hour) is another symptom. [19]
If the degree of bleeding is mild, all that may be sought is the reassurance that there is no sinister underlying cause. If anemia occurs due to bleeding then iron tablets may be used to help restore normal hemoglobin levels. [1] The treatment choices of those referred to hospital in the UK for heavy menstrual bleeding. [20]
Of women with heavy menstrual bleeding, up to 20% will have a bleeding disorder. [24] Heavy menstrual bleeding since menarche is a common symptom for women with bleeding disorders, and in retrospective studies, bleeding disorders have been found in up to 62% of adolescents with heavy menstrual bleeding. [25]
Symptoms of the condition in women may consist of menstrual irregularities, amenorrhea, abnormal vaginal bleeding, and enlargement of the uterus and breasts. [ 1 ] [ 2 ] It may also present as isosexual precocity in children [ 1 ] [ 2 ] and as hypogonadism , gynecomastia , feminization , impotence , and loss of libido in males. [ 3 ]
Symptoms include vaginal bleeding that occurs irregularly, at abnormal frequency, lasts excessively long, or is more than normal. [1] Normal frequency of periods is 22 to 38 days. [1] [3] Variation in the length of time between cycles is typically less than 21 days. [3] Bleeding typically last less than nine days and blood loss is less than 80 mL.
Estrogens can be used to stop bleeding from angiodysplasia. Estrogens cause mild hypercoagulability of the blood. Estrogen side effects can be dangerous and unpleasant in both sexes. Changes in voice and breast swelling is bothersome in men, but older women often report improvement of libido and perimenopausal symptoms.
Symptoms of dysmenorrhea often begin immediately after ovulation and can last until the end of menstruation. This is because dysmenorrhea is often associated with changes in hormonal levels in the body that occur with ovulation. In particular, prostaglandins induce abdominal contractions that can cause pain and gastrointestinal symptoms.
HRT can be used with or without a progestogen to improve symptoms such as hot flashes, sweating, trouble sleeping, vaginal dryness and discomfort. [28] The FDA recommends HRT to be avoided in women with a history or risk of breast cancer, undiagnosed genital bleeding, untreated high blood pressure, unexplained blood clots, or liver disease. [28]