Heavy menstrual bleeding

Not to be confused with Metrorrhagia.

Heavy menstrual bleeding
Other namesHypermenorrhea, menorrhagia
SpecialtyGynecology
Symptomsbleeding more than usual
ComplicationsAnemia, severe pain
Risk factorsfamily history, anovulation, fibroids, polyps, and adenomyosis
Diagnostic methodbased on physical examination
Differential diagnosisIrregular menstruation
Medicationtranexamic acid

Heavy menstrual bleeding (HMB), previously known as menorrhagia or hematomunia, is a menstrual period with excessively heavy flow. It is a type of abnormal uterine bleeding (AUB).[1][2]

Abnormal uterine bleeding can be caused by structural abnormalities in the reproductive tract, anovulation, bleeding disorders, hormonal issues (such as hypothyroidism) or cancer of the reproductive tract. Initial evaluation aims at determining pregnancy status, menopausal status, and the source of bleeding. One definition is bleeding lasting more than 7 days or the loss of more than 80 mL of blood heavy flow.[3]

Treatment depends on the cause, severity, and interference with quality of life.[4] Initial treatment often involve birth control pills. Tranexamic acid, danazol, progesterone IUDs, and NSAIDs are also helpful.[5] Surgery can be an effective for those whose symptoms are not well-controlled with other treatments.[6] Approximately 53 in 1000 women are affected by AUB.[7]

  1. ^ Cite error: The named reference Munro 3–13 was invoked but never defined (see the help page).
  2. ^ Bacon JL (June 2017). "Abnormal Uterine Bleeding: Current Classification and Clinical Management". Obstetrics and Gynecology Clinics of North America. 44 (2): 179–193. doi:10.1016/j.ogc.2017.02.012. PMID 28499529.
  3. ^ O'Brien SH (2018). "Evaluation and management of heavy menstrual bleeding in adolescents: the role of the hematologist". Hematology. 30 (1): 390–398. doi:10.1182/asheducation-2018.1.390. PMC 6246024. PMID 30504337.
  4. ^ Committee on Practice Bulletins—Gynecology (July 2013). "Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction". Obstetrics and Gynecology. 122 (1): 176–85. doi:10.1097/01.AOG.0000431815.52679.bb. PMID 23787936. S2CID 2796244.
  5. ^ Cite error: The named reference BofillRodriguez_2019 was invoked but never defined (see the help page).
  6. ^ Marjoribanks J, Lethaby A, Farquhar C (January 2016). "Surgery versus medical therapy for heavy menstrual bleeding". The Cochrane Database of Systematic Reviews. 2016 (1): CD003855. doi:10.1002/14651858.CD003855.pub3. PMC 7104515. PMID 26820670.
  7. ^ Kjerulff KH, Erickson BA, Langenberg PW (February 1996). "Chronic gynecological conditions reported by US women: findings from the National Health Interview Survey, 1984 to 1992". American Journal of Public Health. 86 (2): 195–9. doi:10.2105/ajph.86.2.195. PMC 1380327. PMID 8633735.