AtoZ Diseases

What is this condition?

This condition refers to any vaginal bleeding that deviates from the normal menstrual cycle before menopause begins. These deviations include menstrual bleeding that’s abnormally infrequent, abnormally frequent, excessive, deficient, or irregular (bleeding between periods). Occasionally, symptoms of menstruation occur without external bleeding (called cryptomenorrhea).

Abmnormal Premenopausal bleeding may merely be troublesome or can cause severe hemorrhage; the prognosis depends on the underlying cause. Abnormal bleeding patterns often respond to hormonal or other therapy.

What Causes it?

• Causes of abnormal premenopausal bleeding vary:
• Abnormally frequent or infrequent bleeding usually results from failure to ovulate because of endocrine or other disorders.
• Excessive bleeding usually results from local lesions, such as uterine tumors, polyps in the endometrium (uterine lining), and endometrial hyperplasia. It may also result from inflammation of the uterus or fallopian tubes and failure to ovulate.
• Deficient bleeding results from local, endocrine, or other disorders or from blockage caused by partial obstruction by the hymen (a membrane at the vaginal opening) or cervical obstruction.
• Bleeding between periods is most commonly no more than a slight bleeding from the endometrium during ovulation. However, it may also result from local disorders, such as malignant uterine tumors, cervical erosions, polyps (which tend to bleed after intercourse), or inappropriate estrogen therapy. Complications of pregnancy can also cause premenopausal bleeding. Such bleeding may be mild or severe .
• Cryptomenorrhea may result from an abnormally closed hymen or cervical narrowing.

What are its symptoms?

Bleeding not associated with abnormal pregnancy is usually painless. but it may be severely painful. When bleeding is associated with abnormal pregnancy, other symptoms include nausea, breast tenderness, bloating, and fluid retention. Severe or prolonged bleeding causes anemia, especially in women with underlying disease (such as a blood disorder) and in women receiving anticoagulants.

How is it diagnosed?

The typical clinical picture confirms abnormal premenopausal bleeding. The doctor will take a health history. Special tests identify. the underlying cause. These may include lab tests of blood hormone levels, endometrial sampling to rule out malignant tumors, a pelvic exam, and a Pap test. A complete blood count helps to eliminate anemia as a cause.

If testing rules out pelvic and hormonal causes of abnormal bleeding, further blood studies may help to determine clotting abnormalities.

How is it Treated?

Treatment depends on the type of bleeding abnormality and its cause. Menstrual irregularity alone may not require therapy unless it interferes with the woman’s attempt to achieve or avoid conception or leads to anemia. When it does require treatment, the drug Clomid induces ovulation. Electrocautery, chemical cautery, or cryosurgery can remove cervical polyps; dilation and curettage, uterine polyps. Organic disorders - such as cervical or uterine cancer - may require hysterectomy, radium or X-ray therapy, or both of these treatments, depending on the site and extent of the disease. Of course, anemia and infections require appropriate treatment.

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