Menorrhagia

As menorrhagia prolonged menstrual period is defined. In a menorrhagia one months period lasts seven to 14 days. It is distinct from the duration of bleeding, which are referred to as a circulation over a period of 14 days. Often the menorrhagia occurs at a hypermenorrhea. The causes hormonal or inflammatory processes can be considered. For clarification include an ultrasound examination of the uterine cavity, the cell examination of the cervix and the exclusion of inflammation. Depending on the findings are, among others, a hormonal therapy or surgical procedures.

  • 2.1 Therapy abnormal, benign uterine bleeding
  • 2.2 dysfunctional therapy, uterine bleeding
  • 2.3 In case of failure of conservative and minimally invasive methods as well as in malignant changes

Causes

Menorrhagia can have various causes. Experts estimate that about 20 % of all women suffer between 30 - 50 years with bleeding disorders.

Excessive bleeding without present, pathological tissue changes in the uterus are also called dysfunctional uterine bleeding (DUB ), while abnormal uterine bleeding (AUB ) denote the bleeding caused by benign tissue changes such as fibroids and polyps, or by malignant tissue changes caused.

It is diagnosed the cause of the particular bleeding disorder by history, gynecological examination and ultrasound. Also required are a hysteroscopy ( hysteroscopy ) and a tissue biopsy ( curettage ) a thorough evaluation of the cause of bleeding.

Malignant tissue changes

On the basis of the retrieved tissue sample, precursors or pre- cancerous altered tissue in the uterus can be seen, then require further treatment by a cancer specialist ( oncologist ).

Benign tissue changes

Are tissue changes in the uterus that can be surgically removed if they cause symptoms (eg, pain, bleeding, infertility ). Benign tissue changes are divided into:

  • Polyps ( protrusions of the uterine lining )
  • Fibroids (benign tumors of muscle tissue)

Based on the assessment made clarification of the type, number, size and location of the benign lesion in the uterine cavity can then be decided on the suitable therapy.

Hormonal disorder

It occurs when the body does not produce estrogen and progesterone in a balanced ratio. This often happens in the period before the start of menopause (pre -menopausal ), particularly in concomitant diseases such as diabetes or obesity. The uterus itself shows no pathological changes here.

Possible, though less common causes, chronic inflammation and side effects of drugs in blood clotting disorders may be.

Therapy

By the previous investigation the underlying cause (malignant, benign change ), the size of the uterus and the size, location and number of changes is uniquely determined. This is the prerequisite for a promising therapy. With knowledge of the number, size and location of the tissue changes or the lack of any tissue change then the following therapies come into question. Generally, the following factors need to be clarified and be considered in the treatment decision:

  • Age of the patient
  • Fertility and fertility potential

Treatment of abnormal, benign uterine bleeding

  • The Polypbehandlung
  • The fibroid treatment

Dysfunctional therapy, uterine bleeding

  • The hormonal treatment
  • The drug treatment with hemostatic drugs
  • Endometrial Ablation

With failure of conservative and minimally invasive methods as well as in malignant changes

  • Hysterectomy
Oligomenorrhea Integrated Authority File
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