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Menorrhagia – Causes and Diagnosis

December 20, 2020


“What are the causes of menorrhagia? Well, there’s a spectrum of things that can cause menorrhagia actually. And what we have to do is when we see a patient that says that they have heavy bleeding, we have to kind of do what I call the detective phase of things and look for all causes. So first we’ll ask a lot of questions describing your bleeding, how often it’s coming, how what’d you have to do as far as changing your paths. And, do you get lightheaded or dizzy? Do you have any pain associated with it? How long has it been going on? Have you had any other stressors in your life and things like that? So we’ll try and take a good thorough history first. And then what we’ll do is we’ll also examine you, we’re going to feel your thyroid because sometimes your thyroid can be a cause of heavy bleeding.

We also will feel your abdomen. We’re checking for masses. Sometimes you can have a very large fibroid uterus that can attribute to heavy bleeding. We’re going to do an exam in the vagina and look and see. Sometimes you can have what we call a polyp. A polyp is a growth that occurs most of the time. They’re benign about 9% of the time. And, but they can cause a disruption in your bleeding pattern and cause you to have heavy bleeding. And then also what we’ll do is we’ll draw some lab work, some things we cannot see, and we just we’ll draw some lab work. Sometimes even your thyroid may feel normal, but it could be your thyroid. It could also be perimenopausal hormones, FSH and LH are two common things that we look for for menopausal evaluation. If you’re older or more seasoned in life, like I like to say, we’re more prone to thinking that that might be a cause, but some people can get premature ovarian failure. So we don’t rule it out for anybody. We check that. If you’re on the younger end, we may check for polycystic ovarian syndrome and there’s some labs that we draw to evaluate for that. And then we also look at, when we’re doing your exam, we’re looking at some features like hirsutism, which is excess hair growth. With your mustache, little, maybe beard, maybe hair on your abdomen or around your breasts. So we’ll look for those things.”

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