Menorrhagia Flashcards
1
Q
What is menorrhagia
A
What the woman considers to be heavy menstrual bleeding
i.e. interferes with QOL
2
Q
No identifiable cause in what %?
A
50%
3
Q
Uterine/ ovarian causes
A
Fibroids Endometriosis Adenomyosis PID Polyps Hyperplasia Carcinoma PCOS
4
Q
Systemic causes
A
Coagulopathies Hypothyroidism DM Hyperprolactinaemia Liver or renal disease
5
Q
Pharmalogical treatment whilst woman is awaiting treatment or referral
A
Tranexamic acid
AND/ OR
NSAID
6
Q
First line if no identified pathology OR fibroids <3mm
Alternative
A
IUS
If declined or unsuitable:
TXA or NSAID can be offered
OR CHC/ oral progestogen
7
Q
Management options for fibroids >3mm (pharmalogical + surgical)
A
Ulipristal acetate (progesterone receptor modulator), IUS, CHC, progestogens
Uterine artery embolisation
Surgery: myomectomy, hysterectomy, endometrial ablation
