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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