Heavy Menstrual Bleeding Flashcards
What are the causes of HMB
Polyps
Adenomyosis
Leiomyoma
Malignancy (endometrial and cervical)
and
Coagulopathy Ovulatory dysfunction Endometrial Iatrogenic Not yet classified
How do leiomyomas causes HMD?
If they cause enlargement of the endometrial cavity
How are leiomyomas present?
Usually asymptomatic
Or pressure, frequency, mentrual disturbance, pregnancy issues
How are leiomyomas mx?
Hormonal
Hysteroscopy resection if submucous
Myomectomy or hysterectomy
Embolisation or ablation with MR guided US
What are red flags for malignancy?
Post coital bleeding
Post menopausal bleeding
How do you investigate post coital bleeding?
STI screening
Colposcopy
When do you think of coagulopathy as a cause of HMB?
Young girls
What is ovulatory dysfunction?
No ovulation, endometrium continues to proliferate, irregular periods
When does ovulatory dysfunction occur normally?
Close to menarche and menopause
What causes anovulation?
PCOS
Thyroid
Weight gain or loss
Pituitary and adrenaline disease
Why does hormone therapy cause HMB?
Incomplete suppression of HPO axis
Over thinning of lining
What is the risk of cancer with taking the pill?
Slightly increases the risk of breast cancer in G0P0
Why do you get breakthrough bleeding when taking constant COCP?
Thinning of endometrium until exposure of vessels
What is a subtotal hysterectomy?
Leave the cervix
