Menorrhagia

Menorrhagia (hypermenorrhoea) is an increase in blood separation. The amount of lost blood is rarely determined, so the diagnosis is purely subjective. Of course, a woman who complains that blood clots, bloodshot sex in the supermarket every month or suffering from anemia during the menstrual period, blood loss is very significant, but in most cases blood loss is low and only hinders active social life.

Causes of bleeding from the vagina. Most likely, women of different ages have different reasons for this. In young girls, pregnancy and dysfunction of the uterus are most likely. At an older age, you can think of the IUD, uterine fibroids, endometriosis and adenomyosis, pelvic infection, polyp. In the period of premenopause, the possibility of carcinoma of the endometrium, hypothyroidism should be taken into account. Ask the patient about bleeding in general, as there may be a dyscrasia (hemostasis violation). Perform a gynecological examination, during which you can identify polyps, uterine fibroids or endometriosis.

Examination. May not be required. Check the blood picture, perform a test for thyroid function. If you suspect a pelvic pathology, you need to perform an ultrasound or laparoscopy. Women in the perimenopausal period need diagnostic scraping to exclude endometrial carcinoma.

To stop severe bleeding from the endometrium appoint norethisterone at a dose of 5 mg every 8 hours inside.

Dysfunctional uterine bleeding. This is an abundant, irregular bleeding associated with the anovulagoric cycle and characteristic for the beginning and end of the reproductive period. If there are no pathological changes in the gynecological examination and you have rejected the presence of organic disorders, this diagnosis can be made by exclusion.

Treatment for menorrhagia. You should pay attention to the main reason. In the presence of dysfunctional uterine bleeding treatment depends on age. It is necessary to convince the patient that she does not have an organ pathology. At a young age, menorrhagia can last until the establishment of regular menstruation and the appearance of ovulation. Too much bleeding can be a reaction of the body to treatment - non-hormonal or hormonal. A woman who has a full-fledged family may prefer a radical solution to the problem - hysterectomy or excision of the endometrium. Otherwise, she will have to wait for menopause.

First of all, you should try to appoint a non-hormonal drug to the patient . They are taken during the period of monthly bleeding, they reduce blood loss. Try to prescribe antagonists of prostaglandins, for example, mefenamic acid at a dose of 500 mg every 8 hours inside after eating; contraindications: peptic ulcers. Antifibrinolytic drugs may be effective, for example tranexamic acid at a dose of 1 to 1.5 g every 6 to 8 hours; contraindications: thromboembolism.

Hormonal therapy. Traditionally, cyclic prostaglandins are used, for example norethisterone at a dose of 5 mg every 8 hours inside or in the second half of the cycle - i.e. From the 19th to the 26th day, or, in the absence of effect, during the whole cycle - i.e. From the 5th to the 26th day (after the drug is discontinued, the patient will have a month). In studies, the effectiveness of these drugs has not been proven. Side effects: weight gain, soreness of the mammary glands, bloating. You can try to appoint combined oral contraceptive pills, but for the elderly there are too many contraindications to the use of these drugs (and in fact, as a rule, they suffer from heavy bleeding). Effective danazol in a dose of 100 mg every 6-24 hours inside (however this is an expensive drug), but the patient may not be happy with side effects: weight gain, acne, muscle pain, amenorrhea. The drug can suppress ovulation, but is not a reliable contraceptive.

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