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Features of Normal Menstrual Blood Loss

(If postmenopausal there should be no vaginal bleeding, however slight and of any colour whether it be a dark brown stain or a bright loss).

Types of Abnormal Uterine Bleeding

(Most problems with genital bleeding in women are a result of uterine function. Occasionally abnormal bleeding results from problems relating to vaginal, vulval, cervical or Fallopian tube problems)

Menorrhagia

Polymenorrhoea

Polymenorrhagia

Oligomenorrhoea

Amenorrhoea

Intermenstrual bleeding

Postcoital bleeding

The Process of Determining the Cause of Problem Genital Tract Bleeding

 

History:

Clinical Examination:

Blood Picture Examination:

More specialized tests such as:

Endometrial Polyp visualized during hysteroscopy (can sometimes be imaged during an ultrasound assessment of the uterus)
Endometrial Polyp visualized during hysteroscopy (can sometimes be imaged during an ultrasound assessment of the uterus)
This atrophic endometrial cavity was noted in a postmenopausal woman who presented with a postmenopausal bleed. The lining was thin and dry with no evidence of endometrial cancer. The appropriate treatment was local oestrogen therapy

 

Radiological Investigations:

 

Causes of Abnormal Menstrual Bleeding

 

Hormonal:

Benign lesions:

Large fibroid filing abdominal cavity removed via open surgery. This uterus has large pedunculated subserosal fibroids as well as intramural fibroids. Submucous fibroids were noted when the uterus was split open after removal

Uterine abnormalities enlarging the cavity - e.g. A double uterus

Uterus didelphys (double uterus)

 

Cancerous lesions:

Drugs:

Endometrial Ablation

 

Contraindications to endometrial ablation:

Types of endometrial ablation systems:

Hysterectomy

Indications:

Types of hysterectomy: