Gynecology Book

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Ovulatory BleedingAka: Menorrhagia

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  1. See Also
    1. Abnormal Uterine Bleeding
  2. Pathophysiology
    1. Shortened or prolonged corpus luteum life span
    2. Abnormal relative ratio of Estrogen to Progesterone
      1. Usually due to low Estrogen levels
  3. Risk Factors
    1. Increases with age
  4. Causes
    1. See Abnormal Uterine Bleeding Causes
    2. Uterine Fibroids before Menopause
    3. Endometrial polyps
    4. Consider Bleeding Disorders (e.g. von Willebrand's)
      1. Common cause of menorrhagia
  5. Symptoms
    1. Premenstrual Symptoms are present
    2. Change in Amount of bleeding, normal cycle intervals
      1. Prolonged bleeding (7 days or more per cycle)
      2. Menorrhagia
        1. Previously defined as >80 ml per cycle
        2. The definition of 80 ml is no longer recommended
          1. Warner (2004) Am J Obstet Gynecol 190:1224
  6. Signs
    1. See Ovulation
  7. Evaluation
    1. See Abnormal Uterine Bleeding
    2. Von Willebrand's Disease testing indications
      1. Adolescents or adults with severe menorrhagia
      2. Women planning Hysterectomy for menorrhagia
    3. ACOG does not recommend routine TSH, Prolactin testing
      1. Menorrhagia is most often due to fibroids or polyps
      2. Important to distinguish from annovulatory bleeding
        1. More often related to endocrine cause
    4. Consider Endometrial Cancer screening
      1. See Abnormal Uterine Bleeding
  8. Management
    1. See Menorrhagia Management
  9. References
    1. Dilley (2001) Obstet Gynecol 97:630

Menorrhagia (C0025323)

Definition (MSH)Excessive uterine bleeding during MENSTRUATION.
Definition (NCI)Abnormally heavy menstrual bleeding.
ConceptsPathologic Function (T046)
ICD9626.2
MSHD008595
BasqueGEHIEGIZKO HILEROKOA
DanishKraftig menstruation
DutchMenorragie
EnglishBLEEDING MENSTRUAL HEAVY, EXCESSIVE MENSES, Flooding during periods, Heavy menstrual period, Heavy period, Heavy periods, Hypermenorrhea, Hypermenorrhea -RETIRED-, Hypermenorrhoea, Hypermenorrhoea -RETIRED-, Menorrhagia, MENSES REGULAR WITH EXCESSIVE BLEEDING, MENSTRUAL FLOW EXCESSIVE, Menstruation excessive, Profuse menstrual flow
FinnishRUNSAAT KUUKAUTISET
FrenchMenstruation excessive
Germanuebermaessige Regelblutung/Menorrhagie
Hungariantulzott merteku verzes
ItalianMestruazione abbondante
NorwegianKRAFTIG MENSTRUASJON
PortugueseMenstruacao excessiva
Spanishexcesivo sangrado menstrual, hipermenorrea, hipermenorrea - RETIRADO -, menorragia, menstruacion abundante, Menstruacion excesiva, menstruacion profusa
SwedishRIKLIG MENSTRUATION
Parent ConceptsHemorrhage (C0019080), Menstruation Disturbances (C0025345), UTERINE/ENDOMETRIAL DISORDERS (C0549623), FEMALE GENITAL SYSTEM (INCLUDING BREAST) (C0497455), Symptoms and Complaints Component (C0497525), Uterine hemorrhage (C0042134), Finding of quantity of menstrual blood loss (C0425949), Duplicate concept (C1274013), Reason not stated concept (C1276325)
SourcesCOSTAR, CSP, CST, DXP, ICPC, ICPCBAQ, ICPCDAN, ICPCDUT, ICPCFIN, ICPCFRE, ICPCGER, ICPCHUN, ICPCITA, ICPCNOR, ICPCPOR, ICPCSPA, ICPCSWE, LCH, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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