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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Spanish version
Illustration
Menorrhagia (Heavy or Extended Menstrual Bleeding)
What is menorrhagia?
Menstrual bleeding lasting more than 7 days or bleeding
that is much heavier than usual for you is called
menorrhagia.
How does it occur?
There are many possible causes of menorrhagia, including:
- hormone imbalance, the most common cause (the imbalance
is sometimes caused by improper use of hormone medicine)
- polyps, which are growths on the cervix (the opening of
the uterus) or inside the uterus; polyps are usually
noncancerous
- fibroids, which are noncancerous growths in the uterus
- a cyst (a sac full of fluid or blood) on the ovary
- use of an IUD (intrauterine device)
- pregnancy complications, including miscarriage, threat
of miscarriage, and ectopic (tubal) pregnancy
- cancer of the uterus or ovary and sometimes cancer of
the cervix
- chronic medical problems (for example, thyroid problems,
diabetes, and blood-clotting problems).
How is it diagnosed?
Your health care provider will ask about your medical
history and menstrual cycles. Your provider may ask you to
keep a diary of bleeding and nonbleeding days, including
notes about how heavy the bleeding was. You will also have
a physical exam.
You may need a blood test or procedure, such as:
- Endometrial biopsy: Your health care provider takes a
sample of tissue from the inside of the uterus. The
tissue is examined under a microscope.
- Ultrasound scan: Sound waves are used to get pictures of
the uterus, ovaries, and pelvis. The ultrasound probe
may be placed on your lower abdomen or into your vagina.
- Sonohysterogram: An ultrasound scan is done after fluid
is injected through a tube into your uterus. This test
allows your provider to look for problems with the lining
of the uterus, such as fibroids.
- Hysteroscopy: Your health care provider inserts a thin
metal tube with a light and tiny camera through the
vagina and cervix and into the uterus. This allows your
provider to see the inside of the uterus.
- Laparoscopy: Your health care provider inserts a thin
metal tube with a light and tiny camera into your
abdomen and pelvis through a small cut in or just below
your bellybutton. Your provider uses the scope to look
at your uterus and other pelvic organs.
- D&C (dilation and curettage): Your health care provider
opens up the cervix and scrapes or suctions tissue from
the lining of the uterus. The tissue is examined in the
lab.
- Hysterosalpingography: Dye is injected into the uterus and
fallopian tubes through the cervix. X-rays are then
taken. The dye outlines the shape and size of the
uterus and tubes.
Many of these procedures may be done in your health care
provider's office. Others may be done in an outpatient
clinic.
How is it treated?
The treatment depends on the cause of the problem. For
example, if you have a hormone imbalance, your health care
provider may prescribe hormones. Sometimes surgery is
needed. Possible surgical treatments include:
- D&C, in which tissue is scraped or suctioned from the
uterus
- hysteroscopy (to remove a polyp, for example)
- endometrial ablation, which is the use of a laser,
electrocautery instrument, or thermal balloon to destroy
the inside lining of the uterus
- hysterectomy, which is removal of the uterus.
Hysterectomy and endometrial ablation are procedures that
will cause you to be sterile, that is, unable to become
pregnant. If you have a hysterectomy, you will stop
having menstrual periods. After endometrial ablation you
should have no or very little menstrual flow, although some
women start having menstrual flow again a while after the
procedure.
How long will the effects last?
How long you have heavy or extended menstrual bleeding
depends on the cause and treatment.
How can I take care of myself?
- If you have unusually heavy bleeding for two menstrual
periods in a row, call your health care provider.
- Follow the treatment recommended by your health care
provider.
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