HEAVY MENSTRAL BLEEDING

One of the reason women visit their general practitioner is because of disorders of the menstrual cycle .It is rarely a life threatening situation but it causes sociological, psychological, and occupational embarrassments.

Heavy menstrual bleeding is abnormalities of menstrual blood loss most often accompanied with pain. The quantity of the blood loss has to be greater than 80ml before it can be acknowledged as heavy menstrual bleeding. Others associated symptoms are irregular bleeding, intermenstrual bleeding, postcoital bleeding, unusual vaginal discharge, urinary symptoms, weight change, skin change, fatigue, family history of bleeding problems, excessive bleeding with dental extraction.

Despite various investigation on heavy menstrual bleeding, most often no pathological reason is identified as the cause. However recent studies have identified bleeding of the endometrial origin to some cases. GP should refer appropriately cases of HMB to the specialist. Examination of the abdominal and pelvic is always needed for palpation of the pelvic mass. Visualisation of the cervix for polyps is needed and cervical smear taken if there is a pelvic infection. Other investigations are full blood count, pelvic ultrasound scan, coagulation screen and endometrial biopsy.