-IBIS-1.5.0-
tx
reproductive system
metrorrhagia
diagnoses

definition and etiology

definition:
Uterine bleeding, usually of normal or slight amount, occurring at completely irregular or regular intervals outside of the normal menstrual flow.

etiology:
There are many causes for metrorrhagia: endometrial cancer; endometrial polyps; atrophic endometritis; exogenous estrogen therapy; uterine fibroids; foreign bodies (such as IUDs); cancer of the fallopian tubes; ovarian cancer; ovarian cysts; blood coagulation disorders (with vaginal and other area bleeding); spontaneous abortion; cervical polyps; endometriosis; adenomyosis; and adenomyomas.

signs and symptoms

signs and symptoms:
The woman is between menarche and menopause.
• Bleeding from the vagina in between her normal periods: may be spotty and slight or heavy enough to require a heavy pad.
• Possible dysmenorrhea may be present in the woman.

lab findings:
• Pap smear.
• Cervical biopsy.
• Diagnostic fractional D&C.
• Pregnancy check.
• Gynecological exam.
• Laparoscopy.
• CBC

course and prognosis

The course is often persistent, with the bleeding remaining the same or getting worse. Conventional sources suggest that "total hysterectomy and bilateral salpingo-oophorectomy may be indicated, despite the failure to find any pathologic changes in the reproductive tract." (Merck). However, many women without any serious pathology causing the condition will respond to proper comprehensive medical approaches. Metrorrhagia should have a full work-up preferably at the beginning of treatment.

differential diagnosis

• determine the cause


footnotes