Menorrhagia

Question 1

Menorrhagia - key symptoms (4)

Answer 1

Excessive bleeding during menstruation
Over 80mL blood loss
Bleeding for more than 7 days
Changing sanitary product every 1-2 hours

Question 2

Menorrhagia - extra questions (5)

Answer 2

Any uterine/ovarian diseases
Any systemic diseases including coagulation, hypothyroidism, diabetes, renal/liver
IUD or chemotherapy
Ask about nature of their periods (cycle length, cycle consistency)
Symptoms of anaemia (fatigue, headache, breathlessness)

Question 3

Menorrhagia - risk factors/causes (4)

Answer 3

Aged 30-40 years
Uterine/ovarian diseases
Systemic diseases
Lactogenic causes (IUD, chemotherapy)

Question 4

Menorrhagia - 1st line treatment (not OTC) but something to recommend

Answer 4

Levonorgestrel IUS (coil)

Question 5

Menorrhagia - OTC treatment option (product, how it works, how to use it and how long to see effects)

Answer 5

Tranexamic acid (Evana)
Antifibrinolytic that works to reduce bleeding and blood loss
2 tablets TDS for 4 days, max 8 tablets/day
18+
Must have regular cycles (21-35 days) and differing by no more than 3 days
Refer if no improvement after 3 cycles

Question 6

Menorrhagia - other treatment options (not OTC) (2)

Answer 6

NSAIDs (mefenamic acid, naproxen), not licensed for OTC use
Combined hormonal contraceptive

Question 7

Menorrhagia - explanation

Answer 7

When the patient experiences excessive bleeding during menstruation

Question 8

Menorrhagia - referral (4)

Answer 8

Fibroids
Iron deficiency anaemia
Post-menopausal bleeding
Unresponsive to tranexamic acid after 3 cycles