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[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 heavy flow. [3] Treatment depends on the cause, severity, and interference with quality of life. [4]
[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 nausea. [1] Dysmenorrhea can occur without an underlying problem.
Lack of a menses by the age of 16 where secondary sexual characteristics have developed or by the age of 14 where no secondary sexual characteristics have developed (primary amenorrhea), or lack of a menses for more than 3–6 months after first menstruation cycle. [2]
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]
[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.
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.
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] Scanty menses or periods can occur normally at the extremes of the reproductive life that is, just after puberty and just before menopause. This is because ovulation is irregular at this time, and the endometrial lining fails to develop normally. But normal problems at other times can also cause scanty blood flow.