Menorrhagia Flashcards
(12 cards)
What defines heavy menstrual bleeding (menorrhagia)?
Blood loss ≥80 mL per cycle and/or bleeding lasting >7 days, requiring frequent product changes (every 1–2 hours). Regularly, every 24–35 days.
What first-line treatment is recommended for HMB with no significant pathology or fibroids <3 cm?
Levonorgestrel-releasing intrauterine system (LNG-IUS).
What should patients be advised about when starting LNG-IUS for HMB?
Irregular bleeding may occur initially, and full benefit may take up to 6 months.
How does the LNG-IUS help reduce heavy menstrual bleeding?
By preventing endometrial proliferation and thickening cervical mucus; it may also suppress ovulation.
What alternatives can be used if LNG-IUS is unsuitable?
Tranexamic acid, NSAIDs, combined hormonal contraceptives, or cyclical oral progestogens.
What is preferred for women with menorrhagia actively trying to conceive?
Non-hormonal treatments such as tranexamic acid or NSAIDs.
What treatment options exist for fibroids ≥3 cm in diameter?
Tranexamic acid, NSAIDs, LNG-IUS, hormonal treatments, ulipristal acetate, uterine artery embolisation, or surgery.
What is ulipristal acetate used for in menorrhagia?
To treat moderate to severe symptoms of uterine fibroids when surgery is unsuitable or has failed.
How does tranexamic acid work?
It inhibits plasminogen activation, reducing fibrinolysis and bleeding.
How do NSAIDs reduce heavy menstrual bleeding?
By inhibiting cyclooxygenase, reducing prostaglandin synthesis involved in bleeding and cramping.
What pre-operative treatment can be used before hysterectomy or myomectomy for fibroids?
Gonadotropin-releasing hormone analogues.
What lab test is essential in all women with heavy menstrual bleeding?
Full blood count to rule out iron deficiency anaemia.
