Irregular menstruation & intermenstrual bleeding

Question 1

What are the possible causes of irregular menstruation & intermenstrual bleeding?

Answer 1

- Anovulatory cycles comming in early/ late reproductive years
Non-malignant causes;
- Fibroids
- Uterine & cervical polyps
- Adenomyosis
- Ovarian cysts
- Chronic pelvic infection
Malignancy (older women);
- Endometrial, ovarian & cervical

Question 2

How would you investigation irregular menstruation & intermenstrual bleeding?

Answer 2

• Hb (anaemia?)
• Cervical smear is required
• US
• Endometrial biopsy + Pipella is endometrial >10mm