Our very own O&G Reg
Video Duration: 9 minutes
Subjectively, menorrhagia is a heavy period. This can be defined as bleeding for more than 7 days or blood loss greater than 80ml.
With a regular cycle and painless:
With a regular cycle and pain:
Short cycle and excessive menses (epimenorrhagia):
Irregular cycles and excessive menses:
Long cycle and excessive menses:
Excessive bleeding with any of following:
Questions to ask in the History...
Endocervical and high vaginal swabs
Clotting (APTT, INR)
Pelvic US - endometrial thickness, polyps, fibroids
Hysteroscopy - closer look at uterus
Information and support - comfort that condition is benign
In women of child-bearing age:
Blood loss >80mL or bleeding for >7 days, or excessive blood loss that interferes with a womens quality of life.
Very common condition, 1/3 of women complain of heavy bleeding.
Signs of anaemia: Increased RR, conjunctival pallor
Abdominal tenderness (fibroids/ masses)
Endocervical and high vaginal swabs - chlamydia or gonorrhoea
FBC (Hb - effect of blood loss)
Clotting (APTT, INR) - clotting disorder?
TFTs - systemic cause?
Transvaginal US - assess endometrial thickness, exclude fibroid or ovarian mass and detect larger polyps
Endometrial biopsy - if endometrial thickness >10mm, polyp suspected, >40 with recent onset menorrhagia, IMB that has not responded to treatment to exclude malignancy
Hysteroscopy - allows further visualisation of the uterus
Support and information about the condition
Trying to conceive:
Not trying to conceive: