Hypermenorrhea
| Classification according to ICD-10 | |
|---|---|
| N92 | Menstruation that is too heavy, too frequent, or irregular |
| ICD-10 online (WHO version 2019) | |
Hypermenorrhea (also called hypermenorrhea) describes a form of the normal type disorder, which is characterized by excessive menstrual bleeding with the loss of blood clots and thus increased blood loss during the menstrual period.
definition
Hypermenorrhea is present when the blood loss per menstrual period is more than 80 ml due to excessive menstrual bleeding with loss of blood clots. One then also speaks of an “excessive bleeding”.
etiology
About 80 percent of the causes of hypermenorrhea are organic, about 15 percent functional (with no known organic cause) and about 5 percent are extragenital. The first organic causes to be mentioned are the ability to contract or contractile disorders of the uterine muscles. If this is reduced by fibroids , intramural endometriosis , uterine hypoplasia or inflammatory processes, or a proper contraction of the uterus is prevented by an intrauterine device , polyps or carcinomas of the endometrium , increased blood loss occurs. Hormonal disorders, such as a progestin deficiency, can affect the uterine lining and cause increased bleeding. Examples of extragenital causes include blood clotting abnormalities and the use of anticoagulants .
Complications
Apart from the impaired quality of life, prolonged hypermenorrhea can lead to anemia (secondary anemia ) with a lack of red blood cells ( erythrocytes ).
Diagnosis
The anamnestic details of the tampon and pad consumption , the extent of the anemia and the loss of blood clots are indications of the severity of the hypermenorrhea. In many cases, the cause of the hypermenorrhea can be determined by a gynecological examination with an ultrasound examination of the uterine cavity.
therapy
In the case of organically and extragenitally caused hypermenorrhoea, causal therapy must be used. In the case of weaker hypermenorrhoea, this is often possible by administering low-dose hormones. In the case of severe hypermenorrhoea, the therapeutic spectrum ranges from high-dose hormone therapy to GnRH analogs and uterotonics to fractional abrasion uteri , whereby the scraping of the uterine lining not only removes the source of bleeding and thereby stops the bleeding, but also enables a pathological-histological assessment becomes. In special cases, hysteroscopic or thermal endometrial ablation can also be used . The choice of treatment method is always made individually after the gynecological examination and in consideration of the age and the findings. A hysterectomy , the removal of the uterus, can be considered as a last resort if family planning has been completed and previous treatment has been unsatisfactory .
See also
- Amenorrhea (lack of menstrual bleeding)
- Hypomenorrhea (weak menstrual bleeding)
- Menstrual cramps
literature
- W. Pschyrembel , G. Strauss, E. Petri: Practical gynecology. 5th edition. Walter de Gruyter, Berlin 1991, ISBN 3-11-003735-1 , p. 468 ff.
