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The initial workup includes exclusion of pregnancy and cancer, by performing a pregnancy test, a pelvic exam and a gynecologic ultrasound. Further workup depends on outcomes of the preceding tests and may include hydrosonography, hysteroscopy, endometrial biopsy, and magnetic resonance imaging. [2]
Intermenstrual bleeding (IMB), or metrorrhagia, is vaginal bleeding at irregular intervals between expected menstrual periods. [1] It may be associated with bleeding with sexual intercourse . [ 2 ] The term metrorrhagia, in which metro means measure and -rrhagia means abnormal flow, [ 3 ] is no longer recommended.
[1] [2] Such bleeding could be visible or external, namely bleeding from the vagina, or it could be internal into the pelvic cavity or form a hematoma. Normal menstruation is not considered a gynecologic hemorrhage, as it is not excessive. Hemorrhage associated with a pregnant state or during delivery is an obstetrical hemorrhage.
Menorrhagia (meno = prolonged, rrhagia = excessive flow/discharge) is an abnormally heavy and prolonged menstrual period. [13] Metrorrhagia is bleeding at irregular times, especially outside the expected intervals of the menstrual cycle.
Metrorrhagia, which generally refers to vaginal bleeding that occurs between the expected menstrual periods. [15] The distinction between irregular cycle lengths and metrorrhagia is not always clear. It may depend on whether the bleeding is regarded as marking the menstrual period (favoring the term "irregular cycles") or being separate from it ...
Metropathia haemorrhagica, also known as metropathia haemorrhagica cystica, is a menstrual disorder which is defined as a specialized type of anovulatory dysfunctional uterine bleeding associated with endometrial hyperplasia and intermenstrual bleeding.
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 ...
Patients may also report urinary frequency and urinary retention. [2] Premenopausal women with hematometra often experience abnormal vaginal bleeding, including dysmenorrhea (pain during menstruation) or amenorrhea (lack of menstruation), while postmenopausal women are more likely to be asymptomatic. [3]