Abnormal menstural bleeding is a disorder that occurs in women of reproductive age characterized by irregular or unusual bleeding occurring with no identifiable anatomic pathology
Etiology
- Adenomyosis
- hormonal imbalance
- pregnancy
- polycystic ovary syndrome
- hypothyroidism
- fibroid tumor
Types
1)oligomenorrhea;
-prolong follicular phase
-bleeding occur at an interval of more than 35 days
2)polymenorrhagia;
-defect of luteal phase
-bleeding occurs at an interval of less than 21 days
3)menorrhagia
-heavy mensural flow occurs(780 ml) for >7 days
Bleeding occurs at normal interval (21-35) days
4)Dysmenorrhea
-painful mensuration in regular cycle
Clinical features;
- bleeding associated with following signs; hypovolemia/hypotension, tachycardia ,diaphoresis & pallor
- pelvic speculum and vaginal examination revels trauma to vaginal wall retained foreign body ,laceration, bleeding from os
- sign of women with polycystic ovary hyperandrogenism ,obesity, palpable ovaries
- on abdominal examination ;tenderness ,palpable masses
Treatment;
medical treatment
-combined oral contraceptives
-levonorgestrel
-NSAIDS
surgical treatment
-endometrial ablation
-hysterectomy