Menorrhagia

DONE BY: HUGH JACOBS & JANISSA BAKSH

 WHAT IS MENORRHAGIA?

MENORRHAGIA IS DEFINED AS HEAVY CYCLICAL MENSTRUAL BLEEDING TAKING PLACE OVER

SEVERAL CONSECUTIVE CYCLES,AT REGULAR INTERVALS. THERE IS A TOTAL MENSTRUAL BLOOD
LOSS OF MORE THAN 80ml PER MENSTRUATION.
IT SHOULD BE NOTED THAT THE MENSTRUAL CYCLE IS JUDGED AS NORMAL BY THE DURATION,
THE AMOUNT AND THE PERIODICITY OF THE MENTRUAL FLOW. USUALLY THE MENSES LAST 5-6
DAYS WITH AN OCCURRENCE OF EVERY 28 DAYS. THE AVERAGE BLOOD LOSS IS 50ml (range
20ml- 80ml).
ABOUT 75 PERCENT OF MENTRUAL BLOOD LOSS OCCURS DURING THE FIRST 2 DAYS OF
BLEEDING.
WOMEN WHO LOSE MORE THAN 80ml PER MENSTRUAL PERIOD FOR SIX MONTHS OR MORE ARE
LIKELY TO DEVELOP IRON DEFICIENCY ANEMIA.
OTHER IMPORTANT DEFINITIONS
MEASUREMENT OF MENSTRUAL BLOOD
LOSS
IT HAS BEEN SHOWN THAT 50% OF WOMEN COMPLAINING OF EXCESSIVELY
HEAVY PERIODS ACTUALLY HAVE LOSSES WITHIN THE NORMAL LIMITS.

THE NUMBER OF PADS OR TAMPONS SOAKED USED IS AN UNRELIABLE INDICATOR

OF THE ACTUAL AMOUNT OF BLEEDING.

AN ACCURATE MEASURMENT OF BLOOD LOSS CAN BE OBTAINED UTILISING A

PICTORIAL BLOOD ASESSMENT CHART (PBAC). THIS HAS A STRONG
CORRELATION WITH THE MEASURED MENTRUAL LOSS. IT IS SIMPLE TO USE AND
PATIENTS ARE ASKED TO QUANTIFY THE AMOUNT OF BLOOD LOSS ON EACH
ITEM OF SANITARY PROTECTION AS MINIMAL, MILD OR SOAKED AND IT IS
RECORDED ON A SIMPLE CHART.

A PBAC SCORE IN EXCESS OF 100 IS EQUIVALENT TO A BLOOD LOSS EXCEEDING

80ml PER CYCLE,
PICTORIAL BLOOD ASESSMENT CHART
PICTORIAL BLOOD ASESSMENT CHART
CONTD
CAUSES OF MENORRHAGIA

PELVIC PATHOLOGY (48.5%) WHICH INCLUDES:

FIBROIDS
ADENOMYOSIS
ENDOMETRIAL POLYPS
ENDOMETRIAL HYPERPLAISA/CARCINOMA
ENDOMETRISOSIS
CAUSES
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CAUSES CONTD

SYSTEMIC DISORDERS (1.0%) WHICH INCLUDES:

INHERITED CLOTTING DEFICENCIES
THROMBOCYTOPENIA
CHRONIC LIVER FAILURE
HYPOTHYROIDISM

ABNORMAL UTERINE BLEEDING (50%)

IATROGENIC CAUSES (0.5%) WHICH INCLUDES:

INTRA UTERINE CONTRACEPTIVE DEVICES
WAFARIN THERAPY
CAUSES