Metrorrhagia: Menstrual Disorders

Reviewed By: Dr. Shruthi Mantri, fertility specialist at Ferty9 Fertility Center, L. B. Nagar

Menstrual irregularities can be a source of significant discomfort and distress for many individuals. One such condition, metrorrhagia, involves abnormal uterine bleeding that occurs in addition to the regular menstrual cycle. This article provides a holistic understanding of metrorrhagia, its causes, diagnosis, and treatment options.

Also read: Vaginal Swelling in Pregnancy: Tips and Remedies

What is Metrorrhagia?

Metrorrhagia, also known as intermittent bleeding, or abnormal uterine bleeding, refers to irregular or excessive bleeding from the uterus that falls outside the typical menstrual cycle pattern. This bleeding can occur at any time during the cycle, including between periods, after sexual intercourse, or after menopause.

Related Read: Tips for Maintaining Optimal Vaginal Hygiene

Can Metrorrhagia be a Sign of Early Menopause?

While metrorrhagia can occur at any age, it is often associated with the transition to menopause, known as perimenopause. During this phase, fluctuations in hormonal levels can lead to irregular bleeding patterns, including metrorrhagia. However, it is essential to note that metrorrhagia can also occur in younger women and may have various underlying causes.

Metrorrhagia Causes

Metrorrhagia can be attributed to several factors, including:

Hormonal Imbalances

An imbalance in female hormones, such as oestrogen & progesterone, can disturb the normal menstrual cycle, leading to metrorrhagia. This can occur during puberty, perimenopause, or as a result of certain medical conditions affecting hormone levels.

Menarche and Menopause

Metrorrhagia is common during the first few years after menarche (the onset of menstruation) and in the years leading up to menopause, as hormonal changes can cause irregular  bleeding patterns.

Stress

It can disrupt the hypothalamic-pituitary-ovarian axis, which regulates the menstrual cycle, potentially leading to metrorrhagia.

Birth Control and Medications

Birth control practices, like intrauterine devices (IUDs) or hormonal contraceptives, can cause irregular bleeding patterns, including metrorrhagia. Additionally, some medications, such as anticoagulants or anti-inflammatory drugs, may also contribute to abnormal vaginal bleeding.

Malnourishment

Severe nutritional deficiencies, eating disorders, or excessive exercise can disrupt the menstrual cycle & lead to metrorrhagia.

Fertility Treatments

Fertility treatments, such as ovulation induction medicines or in vitro fertilisation (IVF), can sometimes cause irregular bleeding patterns, including metrorrhagia.

Underlying Health Conditions

Metrorrhagia can be a symptom of various underlying health conditions, such as uterine fibroids, endometriosis, pelvic inflammatory disease (PID), cervical or uterine polyps, cervicitis or, in rare cases, certain types of cancer. Liver or kidney disease or platelet disorders also affect abnormal bleeding.

Diagnosing Metrorrhagia

Metrorrhagia diagnosis typically involves a combination of the following approaches:

Physical Evaluation:

Doctors will conduct a physical examination, including a pelvic exam, to assess the potential causes of the abnormal bleeding.

Labs and Tests:

Depending on the individual's medical history and physical examination findings, doctors may order additional tests, such as:

  • Blood Tests: To check for anaemia, hormone levels, or other potential underlying conditions.
  • Pregnancy Test: Doctors will conduct a pregnancy test, as a miscarriage can also cause abnormal vaginal bleeding.
  • Imaging Investigations: A pelvic ultrasound or hysteroscopy of the uterine lining (endometrium) helps visualise the uterus and identify any structural abnormalities or growths.
  • Endometrial biopsy: Doctors may extract a small sample of the uterine lining for analysis.

Metrorrhagia Treatment

The treatment approach generally depends on the cause and the severity of the symptoms of metrorrhagia. The following are some common abnormal uterine bleeding treatment options:

Pharmacological Options:

  • Birth control pills or progesterone supplements to regulate the menstrual cycle and control bleeding.

Surgery:

Doctors may suggest surgical interventions in severe cases or when other treatments are ineffective available to treat abnormal uterine bleeding. These include:

  • Hysteroscopy to remove atypical structures in your uterus, like fibroids and polyps
  • Uterine artery embolisation stops the blood supply to fibroids, resulting in their shrinkage.
  • Endometrial ablation destroys the uterus lining by utilising a laser, heat, microwave energy, or freezing.
  • Hysterectomy to remove uterus

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Conclusion

Metrorrhagia, or abnormal vaginal bleeding, can significantly impact an individual's quality of life and wellness. Understanding the potential causes, seeking prompt medical care, and following the recommended treatment plan are essential steps in managing this condition effectively. By addressing metrorrhagia promptly, individuals can alleviate discomfort and reduce the risk of potential complications.

If you are experiencing irregular or abnormal vaginal bleeding, it is crucial to consult with a doctor. They will conduct comprehensive diagnoses and provide a personalised treatment plan to address metrorrhagia. 

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Metrorrhagia: Menstrual Disorders

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FAQ's

What is the difference between metrorrhagia and menorrhagia?

Metrorrhagia refers to irregular or abnormal vaginal bleeding that is not a part of the normal menstrual cycle. On the other hand, menorrhagia specifically describes heavy or prolonged menstrual bleeding during the regular menstrual period.

Are there any risks associated with untreated metrorrhagia?

Untreated metrorrhagia can lead to complications such as anaemia, fatigue, and an increased risk of developing infections or other health issues. Along with physical symptoms, irregular bleeding can cause emotional and psychological stress and disrupt daily activities. It is essential to seek medical attention to identify and address the underlying cause.

Is it safe to exercise during metrorrhagia?

Doctors generally advise avoiding strenuous exercise during episodes of metrorrhagia, as it may exacerbate the bleeding. However, low-impact activities may be permitted, depending on the severity of the bleeding and your doctor's advice.

How long does it typically take to diagnose metrorrhagia?

The time required to diagnose metrorrhagia can vary and depends on the individual's symptoms, medical history, and the complexity of the underlying cause. In some cases, a diagnosis can be made after an initial physical examination and basic tests, while in others, additional testing or evaluation may be necessary.
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