METRORRHAGIA AND MENORRHAGIA - CAUSES .pptx

METRORRHAGIA AND MENORRHAGIA - CAUSES...
ETIO-PATHOGENESIS
Metrorrhagia and menorrhagia are two common gynecological conditions characterized by abnormal uterine bleeding, each presenting distinct patterns of menstrual irregularity.

Metrorrhagia
Metrorrhagia refers to irregular bleeding between menstrual periods, which can occur at unpredictable intervals and may be unrelated to the normal menstrual cycle. This type of bleeding can vary in amount, ranging from light spotting to heavy flow.

Etiopathogenesis of Metrorrhagia
The causes of metrorrhagia can be multifactorial and vary according to the patient's age, underlying medical conditions, and reproductive status. Common etiologies include:

Hormonal imbalances: Dysfunctional uterine bleeding (DUB), particularly in women with anovulation, is a leading cause of metrorrhagia. Estrogen and progesterone imbalance can lead to irregular shedding of the endometrium.

Endometrial pathology: Endometrial hyperplasia, polyps, or even early-stage endometrial cancer can cause irregular bleeding between periods. These conditions are often associated with excessive estrogen stimulation without the balance of progesterone.

Cervical or uterine lesions: Benign lesions like cervical polyps or cervical dysplasia can lead to irregular bleeding. In more severe cases, cervical or uterine cancer can also present with metrorrhagia as a symptom.

Infections: Pelvic inflammatory disease (PID), sexually transmitted infections (STIs), and endometritis can cause inflammation of the uterine lining, resulting in abnormal bleeding.

Contraceptives: The use of intrauterine devices (IUDs) and hormonal contraception, such as oral contraceptive pills, can sometimes lead to breakthrough bleeding or metrorrhagia due to hormonal fluctuations.

Systemic conditions: Thyroid disorders, coagulation defects (e.g., von Willebrand disease), or liver dysfunction can affect the clotting mechanism, contributing to abnormal uterine bleeding.

Menorrhagia
Menorrhagia is defined as abnormally heavy or prolonged menstrual bleeding that occurs during the regular menstrual cycle. It is diagnosed when bleeding lasts for more than seven days or if the blood loss exceeds 80 mL per cycle. This excessive bleeding can lead to significant anemia and affect a woman's quality of life.

Etiopathogenesis of Menorrhagia
Several underlying factors can contribute to menorrhagia, and these can be broadly classified into structural and non-structural causes.

Structural Causes: These include uterine abnormalities that affect the integrity of the endometrium or myometrium:

Fibroids: Uterine fibroids (leiomyomas), particularly submucosal fibroids, can distort the endometrial cavity and cause heavy bleeding during menstruation.
Adenomyosis: This condition occurs when endometrial tissue invades the myometrium (uterine muscle), leading to an enlarged uterus and heavy, painful periods.
Endometrial polyps: These benign growths in the lining of the uterus .

1. METRORRHAGIA & MENORRHAGIA By DR. MD SANEN S. BHMS 2019-BATCH AMSHMC BELGAUM

2. Menorrhagia-

3. Menorrhagia is defined as cyclic bleeding at normal intervals; the bleeding is either excessive in amount(>80 ml) or duration (>7days) or both

4. Causes * Organic * Functional

5. Organic Pelvic- fibroid uterus Adenomyosis Pelvic endometriosis IUCD Systemic Liver dysfunction(cirrhosis) Congestive cardiac failure Severe hypertension

6. Endocrinal *Hyperthyroidism *hypothyroidism Hematological *leukemia * platele deficiency ( thrombcytopenia ) Emotional upset

7. Functional- Disturbed hypothalamo -pituitary-ovarian-endometrial-ovarian-axis Diagnosis - long duration of flow, passage of big clots , use of Increased number of thick sanitary pads ,pallor and low level of hemoglobin gives an idea about the correct diagnosis of & magnitude of menorrhagia Treatment-treatment is appropriate to the cause of menorrhagia