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Contemporary Concepts in Managing Menorrhagia
1Department of Obstetrics and Gynecology, University of Kansas School of Medicine-Wichita.
Medscape Women'S Health
|December 1, 1996
Summary
Menorrhagia, or heavy menstrual bleeding, affects many women and has diverse causes. Exploring alternatives to hysterectomy is crucial, as many uteri removed are disease-free.
Area of Science:
- Gynecology
- Reproductive Health
Background:
- Menorrhagia, defined as menstrual bleeding longer than 7 days or >80mL blood loss, is a common gynecologic complaint affecting 15-20% of women.
- Historically, hysterectomy was the primary treatment for abnormal uterine bleeding, but this is increasingly questioned due to disease-free uteri in 50% of cases.
Purpose of the Study:
- To review the diverse etiologies of menorrhagia.
- To outline diagnostic approaches, including laboratory tests and imaging studies.
- To discuss current and emerging treatment options for menorrhagia.
Main Methods:
- Literature review of menorrhagia causes, diagnostics, and treatments.
- Discussion of endocrinologic and organic etiologies.
- Overview of laboratory tests (e.g., CBC, hormone levels, coagulation studies) and imaging (ultrasound, hysteroscopy).
Main Results:
- Etiologies include endocrine disorders, coagulation issues, infections, iatrogenic causes, and anatomical factors like fibroids and polyps.
- A comprehensive diagnostic workup is essential, as office sampling can miss pathologies.
- Medical treatments (e.g., NSAIDs, hormonal therapies) and surgical options (D&C, hysterectomy, ablation) exist.
Conclusions:
- Accurate diagnosis of menorrhagia requires a thorough evaluation, considering various potential causes.
- Minimally invasive treatments and alternatives to hysterectomy are increasingly important.
- Further research into novel treatments for abnormal uterine bleeding is warranted.