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During the reproductive years, bleeding that is excessively heavy (menorrhagia or heavy menstrual bleeding), occurs between monthly menstrual periods (intermenstrual bleeding), occurs more frequently than every 21 days (abnormal uterine bleeding), occurs too infrequently (oligomenorrhea), or occurs after vaginal intercourse (postcoital bleeding ...
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]
A normal menstrual cycle is 21–35 days in duration, with bleeding lasting an average of 5 days and total blood flow between 25 and 80 mL. Heavy menstrual bleeding is defined as total menstrual flow >80ml per cycle, soaking a pad/tampon at least every 2 hours, changing a pad/tampon in the middle of the night, or bleeding lasting for >7 days.
Hormonal therapies to reduce or stop menstrual bleeding have long been used to manage a number of gynecologic conditions including menstrual cramps (dysmenorrhea), heavy menstrual bleeding, irregular or other abnormal uterine bleeding, menstrual-related mood changes (premenstrual syndrome or premenstrual dysphoric disorder), and pelvic pain due to endometriosis or uterine fibroids.
The first day of menstrual bleeding is the date used for the last menstrual period (LMP). The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women, and 21 to 35 days in adults. [2] [3] The average length is 28 days; one study estimated it at 29.3 days. [10]
Variation of 21 days or more is considered very irregular. [6] Alternatively, a single menstruation cycle may be defined as irregular if it is less than 24 days or more than 38 days. [7] If they are regularly shorter than 21 days or longer than 36 (or 35) days, the condition is termed polymenorrhea or oligomenorrhea, respectively. [8]
Dysmenorrhea, also known as period pain, painful periods or menstrual cramps, is pain during menstruation. [4] [5] [2] Its usual onset occurs around the time that menstruation begins. [1] Symptoms typically last less than three days. [1] The pain is usually in the pelvis or lower abdomen. [1] Other symptoms may include back pain, diarrhea or ...
It is thus a progesterone withdrawal bleed. As there is no progesterone in the anovulatory cycle, bleeding is caused by the inability of estrogen—which needs to be present to stimulate the endometrium in the first place—to support a growing endometrium. Anovulatory bleeding is hence termed 'estrogen breakthrough bleeding'.