Heavy menstrual bleeding

Question 1

Menorrhagia (heavy menstrual bleeding)

Answer 1

= excessive menstrual blood loss of 80 mL or more, &/or >7 days, = change menstrual products every 1–2 hours
~ Heavy menstrual bleeding occurs regularly, every 24–35 days

Question 2

In females with Menorrhagia + unidentified pathology, fibroids <3 cm causing no distortion of uterine cavity, or suspected or diagnosed adenomyosis

Answer 2

~ levonorgestrel-releasing intrauterine system = 1st-line tx option
~ advised that irregular menstrual bleeding can occur particularly during first months of use and full benefit of treatment may take at least 6 months

alternative = NSAIDs/Tranexamic acid/ COC/ POP

Question 3

In females with fibroids of 3 cm or more in diameter

Answer 3

~ referral
~ Tranexamic acid / NSAID/ IUD / COC / POP/ surgery