Heavy menstrual bleeding management

Question 1

what is it also known as?

Answer 1

menorrhagia

Question 2

ix

Answer 2

fbc

tv us if pain suggesting structural abnormality

Question 3

mx if does not require contraception

Answer 3

mefanamic acid

or

transexemic acid

if no improvement refer

Question 4

if requires contraception

Answer 4

IUS - mirena 1st line

COCP

Long acting prostogens

Question 5

what can be used for short term option to atop heavy menstrual bleeding

Answer 5

Norethisterone 5 mg tds

Question 6

causes

Answer 6

dysfunctional uterine bleeding: this describes menorrhagia in the absence of underlying pathology. This accounts for approximately half of patients

anovulatory cycles: these are more common at the extremes of a women’s reproductive life

uterine fibroids

hypothyroidism

intrauterine devices*

pelvic inflammatory disease

bleeding disorders, e.g. von Willebrand disease