Menorrhagia is an abnormally heavy and prolonged menstrual period at regular intervals
Pre-testicular causes
Pre-testicular factors refer to conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health including:
- Excessive menses but normal cycle:
- Painless:
- Fibroids ( leiomyoma )
- Ovarian endocrine disorder (dysfunctional uterine bleeding or DUB)(the most common cause)
- Coagulation defects (rare)
- endometrial carcinoma
- endometrial polyp
- Painful:
- Pelvic inflammatory disease
- Endometriosis
- adenomyosis
- Short cycle (<21 days) but normal menses (epimenorrhoea or polymenorrhoea). These are always anovulatory cycles due to hormonal disorders.
- Short cycle and excessive menses (epimenorrhagia) due to ovarian dysfunction and may be secondary to blockage of blood vessels by tumours.
- Excessive menses and long intervals.
- Anovular ovarian disorder due to prolonged oestrogen production.
- This may occur following prolonged continuous courses of the combined oral contraceptive pill (e.g. where several packets are taken without a withdrawal gap in order to defer menstruation).
Treatment of Menorrhagia
Where an underlying cause can be identified, treatment may be directed at this.
