Menorrhagia

from Wikipedia, the free encyclopedia
Classification according to ICD-10
N92 Menstruation that is too heavy, too frequent, or irregular
ICD-10 online (WHO version 2019)

A prolonged menstrual period is defined as menorrhagia . With menorrhagia, menstrual periods last seven to 14 days. It is differentiated from continuous bleeding, which is referred to as bleeding over a period of 14 days. Often menorrhagia occurs with hypermenorrhea . Hormonal or inflammatory processes are possible causes. The clarification includes an ultrasound examination of the uterine cavity, cell examination of the portio and the exclusion of inflammation. Depending on the findings, hormonal therapy or surgical procedures are available , among other things .

causes

Menorrhagia can have several causes. According to expert estimates, around 20% of all women between 30 and 50 years of age suffer from bleeding disorders.

Excessive bleeding without any abnormal tissue changes in the uterus is also known as dysfunctional uterine bleeding (DUB), while abnormal uterine bleeding (AUB) describes the bleeding caused by benign tissue changes such as B. fibroids and polyps or malignant tissue changes.

The cause of the respective bleeding disorder is diagnosed through anamnesis, gynecological examination and ultrasound. In addition, a hysteroscopy and tissue removal (abrasion) are required to determine the exact cause of the bleeding.

Malignant tissue changes

The tissue sample taken can be used to identify preliminary stages or tissue that has already been malignantly changed in the uterus, which then require further therapy by a cancer specialist (oncologist).

Benign tissue changes

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

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

Based on the clarification of the type, number, size and location of the benign changes in the uterine cavity, a decision can then be made on the most 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 onset of menopause (pre-menopausal), especially with accompanying diseases such as diabetes or obesity. The uterus itself shows no pathological changes here.

Possible, albeit less common, causes can also be chronic inflammation and side effects of medication for blood clotting disorders.

therapy

The previous examination clearly identifies the underlying cause (malignant, benign change), the size of the uterus, and the size, location and number of changes. This is the prerequisite for a promising therapy. With knowledge of the number, size and position of the tissue changes or the absence of any tissue changes, the following therapies are possible. Basically, the following factors must be clarified and taken into account when making a therapy decision:

  • Patient's age
  • Desire for children or potential desire for children

Treatment of abnormal, benign uterine bleeding

  • the polyp treatment
  • the fibroid treatment

Therapy of dysfunctional uterine bleeding

  • the hormonal treatment
  • the drug treatment with hemostatic drugs
  • the endometrial ablation

If the conservative and minimally invasive methods fail, as well as malignant changes

See also

swell