Aetiology
The causes of menorrhagia may be classified into:
- pelvic pathology:
- pelvic endometriosis
- pelvic inflammatory disease
- endometrial hyperplasia
- uterine fibroids
- systemic disorders:
- hypothyroidism - but usually presents with amenorrhoea in advanced cases
- blood clotting disorders - very rare; examples include von Willebrand's disease, thrombocytopenia
- iatrogenic factors:
- intra-uterine contraceptive device
- misoprostol
- poorly-controlled anticoagulant therapy
- psychosomatic disturbance - usually subsides when precipitating factors subside
- dysfunctional uterine bleeding - if all other local and systemic causes have been excluded
Reference
- Munro MG, Critchley HOD, Broder MS, et al. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011 Apr;113(1):3-13.
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