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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]
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.
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 ...
[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.
It can be distinguished from metrorrhagia by its regularity. [3] Polymenorrhea can be contrasted with oligomenorrhea, in which menstrual cycles are greater than 35 or 37 days in length. [3] [12] The condition can also be distinguished from polymenorrhagia, which is a combination of polymenorrhea and menorrhagia (heavy menstrual bleeding). [1]
Medical tests include a blood test, to see whether the abnormal bleeding has caused anemia, and a pelvic ultrasound, to see whether the abnormal bleeding is caused by a structural problem, such as a uterine fibroid. [2] Ultrasound is specifically recommended in those over the age of 35 or those in whom bleeding continues despite initial ...
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.
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.