Medication
21-day continuous progestin therapy is the most effective short-term medical treatment of menorrhagia, but patient satisfaction is higher with the levonorgestrel-releasing intrauterine device. The levonorgestrel-releasing intrauterine device is an effective long-term option for menorrhagia if future childbearing is desired.
Procedures
Menorrhagia is defined as excessive uterine bleeding occurring at regular intervals or prolonged uterine bleeding lasting more than seven days. The classic definition of menorrhagia (i.e., greater than 80 mL of blood loss per cycle) is rarely used clinically.
Nutrition
Doctors can be certain of a diagnosis of menorrhagia only after ruling out other menstrual disorders, medical conditions or medications as possible causes or aggravations of this condition. Specific treatment for menorrhagia is based on a number of factors, including:
What is the most effective treatment for menorrhagia?
Although you may need a general anesthetic, it's likely that you can go home later on the same day. An abdominal myomectomy or a hysterectomy usually requires a hospital stay. When menorrhagia is a sign of another condition, such as thyroid disease, treating that condition usually results in lighter periods.
What is the meaning of menorrhagia?
Can doctors be certain of a diagnosis of menorrhagia?
Does menorrhagia require a hospital stay after surgery?
How to treat menorrhagia?
You may need surgical treatment for menorrhagia if medical therapy is unsuccessful. Treatment options include: Dilation and curettage (D&C). In this procedure, your doctor opens (dilates) your cervix and then scrapes or suctions tissue from the lining of your uterus to reduce menstrual bleeding.
What is the best treatment for menorrhagia?
Oral progesterone. The hormone progesterone can help correct hormone imbalance and reduce menorrhagia. Hormonal IUD (Liletta, Mirena). This intrauterine device releases a type of progestin called levonorgestrel, which makes the uterine lining thin and decreases menstrual blood flow and cramping.
How to remove fibroids?
Depending on the size, number and location of the fibroids, your surgeon may choose to perform the myomectomy using open abdominal surgery, through several small incisions (laparoscopically), or through the vagina and cervix (hysteroscopically).
How are embolic agents injected into the uterine artery?
Small particles (embolic agents) are injected into the uterine artery through a small catheter. The embolic agents then flow to the fibroids and lodge in the arteries that feed them. This cuts off blood flow to starve the tumors.
What is the best medicine for menstrual bleeding?
Tranexamic acid. Tranexamic acid (Lysteda) helps reduce menstrual blood loss and only needs to be taken at the time of the bleeding. Oral contraceptives. Aside from providing birth control, oral contraceptives can help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding.
How to prepare for a menstrual cycle appointment?
What you can do. To prepare for your appointment: Ask if there are any pre-appointment instructions. Your doctor may ask you to track your menstrual cycles on a calendar, noting how long they last and how heavy the bleeding is. Write down any symptoms you're experiencing, and for how long.
What tests are done to check for uterine problems?
During this test, a fluid is injected through a tube into your uterus by way of your vagina and cervix. Your doctor then uses ultrasound to look for problems in the lining of your uterus. Hysteroscopy.
Why do we do bimanual exam?
A bimanual exam will also be essential to evaluate for uterine abnormalities and enlargement caused by leiomyomas, or cervical abnormalities caused by polyps or cervical cancer. Evaluation. Laboratory evaluation of the patient is essential in guiding the treatment and management of the patient.
What is abnormal uterine bleeding?
Abnormal uterine bleeding, or menorrhagia as previously classified, is a predominant complication among women in the United States that is related to the major impacts of women's quality of life, productivity, and healthcare cost. Reports are that the annual prevalence rate is 53 per 1000 women.[3]
How long does a molimina last?
The normal menstrual cycle, on average, lasts 4-9 days with a blood loss of less than 80 mL. Molimina symptoms like cramping, mood swings, breast tenderness, and fluid retention precede menstruation. Pregnancy or ectopic pregnancy can often present with vaginal bleeding.
What are the labs for a patient?
The initial labs on every patient include complete blood count, blood type and crossmatch, and a pregnancy test. Additional important tests for guiding care for the patient include thyroid-stimulating hormone, iron studies, liver function test, and sexually transmitted disease testing.
What factors should be considered when selecting the appropriate medical treatment for menorrhagia?
Factors taken into consideration when selecting the appropriate medical treatment include the patient's age, coexisting medical diseases, family history, and desire for fertility.
What is the first line of treatment for menorrhagia?
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line medical therapy in ovulatory menorrhagia. Studies show an average reduction of 20-46% in menstrual blood flow. [ 29] NSAIDs reduce prostaglandin levels by inhibiting cyclooxygenase and decreasing the ratio of prostacyclin to thromboxane. NSAIDs are ingested for only 5 days of the entire cycle, limiting their most common adverse effect of stomach upset.
Why is dilation and curettage not used?
Dilatation and curettage. A D&C should be used for diagnostic purposes. It is not used for treatment because it provides only short-term relief, typically 1-2 months. This procedure is used best in conjunction with hysteroscopy to evaluate the endometrial cavity for pathology.
What is the best medicine for menorrhagia?
Progestin is the most frequently prescribed medicine for menorrhagia. Therapy with this drug results in a significant reduction in menstrual blood flow when used alone. Progestin works as an antiestrogen by minimizing the effects of estrogen on target cells, thereby maintaining the endometrium in a state of down-regulation. Common adverse effects include weight gain, headaches, edema, and depression.
Can you use a thermal balloon in an irregular uterine cavity?
Uterine balloon therapy cannot be used in irregular uterine cavities because the balloon will not conform to the cavity.
Can a myomectomy be used for menorrhagia?
Myomectomy can be useful in women who wish to retain their uterus and/or fertility. Since myomectomy can be associated with large blood loss, this procedure is often reserved for cases of a single or few myomas. Risks include large blood loss or recurrence. Hysterectomy provides definitive cure for menorrhagia.
Does levonorgestrel cause uterine bleeding?
The levonorgestrel intrauterine system reduces menstrual blood loss by as much as 97% [ 32] It is comparable to transcervical resection of the endometrium for reduction of menstrual bleeding [ 33, 34, 35] Adverse effects include uterine bleeding or spotting, headache, ovarian cysts, vaginitis, dysmenorrhea, and breast tenderness.
What is primary amenorrhea?
Primary amenorrhea. A 14-year-old woman presents to clinic with some frustration over never having a menstrual period. She is short in stature and has Tanner stage 2 breast development. As you begin a gynecological exam, you realize that you cannot pass a speculum into the vagina.
Why is my 17 year old girl in clinic?
A 17-year-old girl is seen in clinic due to complaints of excessive body hair. She denies taking any medication. She has irregular menses and denies sexual activity. On exam, her BMI is 31, with moderate hirsutism on upper lip and chest, moderate acne on her face, Tanner 5 breasts and pubic hair.
Why do 16 year olds have periods?
You are seeing a 16-year-old girl in clinic because of menstrual irregularity. She had menarche at 12 years of age and since then has had irregular menses that occur every 80 to 90 days. Her periods last for five to seven days with moderate amount of bleeding.
How long has a 13 year old been menstruating?
A 13 year old girl has been menstruating for about 1 year without any difficulties. For the past 2 months, however, she has experienced cramping and diarrhea for the first 2 days of her periods severe enough to keep her out of school. She states she has never had sexual intercourse. Her physical examination is normal.
Does a 52 year old woman have hot flashes?
You have been monitoring a 52-year-old perimenopausal woman's hot flashes. She has not had a hysterectomy. Her symptoms have been so mild that she does not require medication. However, for the past two months, her hot flashes have increased in frequency, duration and intensity.
Which aggregating agent is the only one that includes a single wave response preceded by a lag phase
Collagen is the only aggregating agent that includes a single wave response preceded by a lag phase. During the lag phase collagen stimulates platelets to release their granule contents. Endogenous ADP released from the platelets then initiates irreversible platelet aggregation.
Which aggregating agent gives biphasic patterns?
Epinephrine is the only aggregating agent listed that typically gives a biphasic pattern. ADP and thrombin also give biphasic patterns when used in optimal concentration. 7) The platelet aggregation pattern (after addition, a slight drop and then curved increase to plateau) is characteristic of the aggregating agent:
