Abnormal bleeding
A bleeding disorder, abnormal uterine bleeding, is a common problem in women of childbearing age. The condition impairs the patient’s quality of life, causing physical and psychological abnormalities.
It accounts for nearly a third of gynaecological disorders in the childbearing years and over 70% in postmenopause. In addition to abnormal uterine bleeding, the syndrome of haemophilia is often associated with severe lower abdominal and lower back pain. When do we talk about abnormal bleeding?
A woman’s menstrual cycle lasts between 21 and 38 days, and the bleeding usually lasts 5 days. Most of the bleeding stops in the first 3 days. Abnormal bleeding is defined as bleeding that is different in both duration and amount. The origin of the bleeding disorder is age specific. In young age, it is usually due to hormonal dysfunction, whereas as age advances, structural disorders of the uterus become more prominent.
Therapy
Accurate and thorough examination is essential to choose the right therapy.
In addition to a painless physical examination, imaging (UH, CT, MRI) and laboratory tests are necessary to determine the origin. None of these are painful. If the cause is not anatomical or structural, we will opt for medication in the first instance, while in the case of structural abnormalities, we will recommend surgical treatment. Depending on the size and location of the abnormality, the surgical intervention can range from an ambulatory solution to hysterectomy under anaesthesia. Naturally, minimally invasive surgical procedures are preferred. Often, a hysteroscopy under short anaesthesia is sufficient, during which we can remove the isolated polyp or the entire endometrium.
A common cause of anaemia is a benign uterine myoma, which can also be reduced by hysteroscopy or removed by keyhole surgery (laparoscopy) while preserving the uterus. Elimination of the bleeding disorder depends on OTC therapy. If the cause is found and treated properly, patient satisfaction will be the reward.
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