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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 .
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.
This type of dysmenorrhea is called primary dysmenorrhea. [5] Primary dysmenorrhea usually begins in the teens soon after the first period. [13] Secondary dysmenorrhea is the type of dysmenorrhea caused by another condition such as endometriosis, uterine fibroids, [5] uterine adenomyosis, and polycystic ovary syndrome.
One cause of hypomenorrhea is Asherman's syndrome (intrauterine adhesions), of which hypomenorrhea (or amenorrhea) may be the only apparent sign.The degree of menstrual deficiency is closely correlated to the extent of the adhesions.
The treatment choices of those referred to hospital in the UK for heavy menstrual bleeding. [20] The first line treatment option for those with HMB and no identified pathology, fibroids less than 3 cm in diameter, and/or suspected or confirmed adenomyosis is the levonorgestrel-releasing intrauterine system (LNG-IUS). [16]
Diagram illustrating how the uterus lining builds up and breaks down during the menstrual cycle Menstruation (also known as a period, among other colloquial terms) is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hormones. Menstruation is triggered by falling progesterone ...
Cancer of the uterus is always a concern, specifically when the bleeding occurs after menopause. Other types of cancer include cervical cancer; bleeding in that case can sometimes be triggered by postcoital bleeding. Cancers of the vagina or fallopian tubes are rare causes of hemorrhage.
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.