12: HMB Flashcards
1
Q
What is heavy menstrual bleeding?
A
Excessive menstrual blood loss that interferes with a woman’s QoL
2
Q
What are the main causes of HMB?
A
- Idiopathic
- Uterine: fibroids, endometrial ca, endometriosis,
- Cervical: cancer
- Systemic: thyroid disease, clotting disorder
3
Q
Hx for HMB?
A
Hx
- Bleeding history: how much, IMB/PCB, irregular/regular, length of cycles
- Impact on function
- Pain
- Associated symptoms
- Sx thyroid disease
- Constitutional sx
4
Q
Ix for HMB
A
Bloods: FBC, TFT
Urine: MSU
Swabs: if indicated
Smears if not UTD
Imaging:
- USS + pipelle
- Consider hysteroscopy for high risk
5
Q
What medical tx for HMB?
A
Non hormonal: TXA, NSAIDs (before menstruation 3-5 days)
Hormonal: Mirena, POP (norethisterione 5mg TDS day 5-26), Depot, COC
6
Q
Surgical tx for HMB
A
Endometrial ablation
Hysterectomy
