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Related Experiment Video

Updated: Mar 6, 2026

Herbs-Partitioned Moxibustion on the Navel in a Rat Model of Primary Dysmenorrhea with Cold Coagulation and Blood Stasis
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Heavy menstrual bleeding: An update on management.

Joanna Davies1, Rezan A Kadir1

  • 1The Haemophilia Centre and Thrombosis Unit and Department of Obstetrics and Gynaecology, The Royal Free Hospital, London, United Kingdom.

Thrombosis Research
|March 7, 2017
PubMed
Summary
This summary is machine-generated.

Heavy menstrual bleeding (HMB) affects quality of life and may indicate an underlying bleeding disorder. Management options range from hormonal treatments and hemostatic agents to surgical procedures like endometrial ablation or hysterectomy.

Keywords:
Combined hormonal contraceptivesHormonal therapyInherited bleeding disordersLevonorgestrel-releasing intrauterine system (LNG-IUS)Menorrhagia

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Area of Science:

  • Gynecology
  • Hematology

Background:

  • Heavy menstrual bleeding (HMB) is excessive menstrual blood loss (>80 mL/cycle) impacting physical, emotional, and social well-being.
  • Causes include uterine pathologies, coagulopathy, ovulation dysfunction, or iatrogenic factors, with up to 20% of HMB cases linked to inherited bleeding disorders (IBD).

Observation:

  • Assessment involves menstrual/gynecological history, bleeding scores, pelvic exams, and ultrasounds to identify underlying causes.
  • Distinguishing HMB causes is crucial for targeted investigations and management.

Findings:

  • Medical therapies include hormonal treatments (levonorgestrel-releasing intrauterine system, combined hormonal contraceptives) and ulipristal acetate for uterine fibroids.
  • Hemostatic therapies like tranexamic acid and DDAVP are effective, particularly for HMB associated with IBDs.
  • Severe IBD-associated HMB may necessitate factor concentrate administration; endometrial ablation and hysterectomy are surgical options.

Implications:

  • Personalized management strategies are essential, considering the underlying cause and patient preferences (including fertility wishes).
  • Effective treatment of HMB can significantly improve a woman's quality of life.
  • Further research into the optimal management of HMB, especially concerning IBDs, is warranted.