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Menorrhagia
Published in Charles Theisler, Adjuvant Medical Care, 2023
Menorrhagia is the medical term for menstrual periods with abnormally heavy (passing clots the size of a quarter or larger or needing to change a tampon or pad after less than two hours)1 or prolonged (more than seven days) bleeding that is often accompanied by severe pelvic pain. It is one of the most common gynecologic complaints. If the condition becomes chronic, anemia from recurrent excessive blood loss may result. Low hemoglobin levels reduce the blood's capacity to carry oxygen, leading to extreme tiredness, fatigue, unusual weakness, and shortness of breath.
Some particular challenges
Published in Roger Neighbour, Jamie Hynes, Helen Stokes-Lampard, Consulting in a Nutshell, 2020
Roger Neighbour, Jamie Hynes, Helen Stokes-Lampard
There is far more here than can be competently dealt with in a single appointment, even if you are prepared to let it overrun by a few minutes. Menorrhagia is a symptom of several conditions, not all of which are benign. The insomnia may indicate depression, something which ideally you would like to explore. The blood pressure check could be done by a nurse; but then, it probably would only take you a minute. Writing letters to Local Authority housing departments, you know from experience, is tedious and usually futile. The effect of this lengthy agenda and its implications is to produce in you a heart-sink reaction which may carry over and contaminate your dealings with subsequent patients.
DRCPG MCQs for Circuit A Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Chronic PID can present with symptoms of menorrhagia, congested dysmenorrhoea, pelvic pain, persistent mucopurulent vaginal discharge and sterility. Menorrhagia is associated with hypothyroidism and not hyperthyroidism. The causes of menorrhagia are legion and include adenomyosis (internal endometriosis), anticoagulation therapy, bicornuate uterus, blood dyscrasias, endometrial polyps, fibroids, IUD, hormonal and physiological factors.
Ultrasound assessment of uterine morphology in menorrhagia: case control study
Published in Journal of Obstetrics and Gynaecology, 2020
Menorrhagia is defined as abnormally heavy or prolonged menstrual bleeding affecting a woman’s quality of life. Previously, Chen et al. (2015) defined menorrhagia as total menstrual blood loss (MBL) exceeding 80 mL per cycle or menses lasting longer than 7 days. This definition represents clinically significant increased MBL greater than two standard deviations above average. Its application, however, is impractical outside of a research setting and has been largely superseded by the former. Deuholm et al. (2001) and George and Bourne (2003) both stated that about 30% of women describe heavy menstruation; however, subjective assessment of menstrual blood loss according to studies performed by Sheil and Turner (1996) and Deuholm et al. (2001) does not always correlate with clinically-measured blood loss volumes.
A comparison of the pregnancy outcomes between ultrasound-guided high-intensity focused ultrasound ablation and laparoscopic myomectomy for uterine fibroids: a comparative study
Published in International Journal of Hyperthermia, 2020
Guangping Wu, Rong Li, Min He, Yuanfang Pu, Jishu Wang, Jinyun Chen, Hongbo Qi
Inclusion criteria were as follows: (1) women who desire fertility or a pregnancy plan; (2) women who have a regular sexual life and do not use contraception postoperatively; (3) women with symptomatic fibroids confirmed by an imaging examination and with any of the following indications for intervention: (a) enlarged uterus (uterine volume equal to or larger than that at 10 week’s gestation); (b) menorrhagia and/or secondary anemia; (c) pelvic pain, frequent urination, or constipation; (4) women who had fewer than three fibroids with an individual diameter larger than 2 cm, as visualized by pelvic ultrasonography; and (5) women who chose to be treated with USgHIFU ablation and had fibroids clearly detected by ultrasonography. For patients with abdominal surgical scars, the range of the blurred image caused by acoustic attenuation should be <10 mm.
Self-reported reproductive health experiences in women with von Willebrand disease: a qualitative interview-based study
Published in Journal of Obstetrics and Gynaecology, 2019
Ariela L. Marshall, Harika Dasari, Nathaniel D. Warner, Diane E. Grill, William L. Nichols, Rajiv K. Pruthi
Women with VWD often experience heavy menstrual bleeding (menorrhagia), and while VWD affects less than 1% of the population it is diagnosed in over 10% of women with menorrhagia (Lukes et al. 2005). The options for the treatment of menorrhagia in these women include combined oral contraceptives, intrauterine devices, endometrial ablation and desmopressin. Von Willebrand factor (VWF) levels rise in most women during the course of pregnancy, and therefore a specific treatment is often not needed. However, miscarriages and threatened miscarriages do occur, especially when the VWF levels are low. Additionally, VWF levels fall rapidly after delivery and women with VWD are at a significantly increased risk of an immediate and delayed postpartum haemorrhage (Kadir et al. 1998; Nichols et al. 2008). Despite the significant amount of scientific literature regarding the pathophysiology of VWD and the increased risk of bleeding in these patients, and despite the fact that this has led to multiple management recommendations especially for women with regards to menorrhagia and pregnancy, there is little in the literature about the women’s decision-making processes regarding reproductive health. Our aim was to provide more patient-reported data in this area, as the authors believe this will be beneficial to the medical community, and to the patients with VWD and their families.