Abnormal uterine bleeding Flashcards
1
Q
What constitutes abnormal uterine bleeding?
A
- Bleeding between periods
- Bleeding after intercourse
- Heavy bleeding
- Menstrual cycle <24 days or >38 days
- Cycle length varying by more than 7-9 days
- Post-menopausal bleeding
2
Q
What constitutes heavy bleeding?
A
Blood loss of over 60ml during menstruation (however treatment is based on patient experience)
3
Q
What should you ask about when taking a history for heavy bleeding?
A
- Use of double protection
- Changing at night
- Flooding and leaking
- Large blood clots
- Symptoms of anaemia
4
Q
What causes heavy bleeding?
A
- Fibroids
- IUD
- Endometriosis
- PID
- Clotting disorders
- Polyps
- Hypothyroidism
- Anticoagulant medication
- Uterine cancer
- Impact on work
5
Q
How can heavy bleeding be managed?
A
- Mirena coil (also acts as contraceptive)
- Tranexamic acid or NSAIDS
- GnRH analogue
- Fibroid removal
- Endometrial ablation (SE of sterilisation)
- Hysterectomy (SE of sterilisation)
6
Q
What is secondary amenorrhoea?
A
When periods stop for 6 months or more
7
Q
What can cause irregular menstrual/intermenstrual bleeding?
A
Cervical polyps, fibroids, cysts and chronic PID.
In older women, likelihood of malignancy is slightly raised
8
Q
What causes dysmenorrhoea?
A
High levels of prostaglandin in the endometrium, often due to pelvic pathology, fibroids, endometriosis, PID.
