Menometrorrhagia is defined as prolonged uterine bleeding that occurs at irregular intervals and more frequently than the expected normal menstrual cycle of a woman.
A woman of reproductive age experiences a monthly cycle or menstruation due to the rise and fall in hormones. Menstrual blood is a composition of blood and tissues that shed in the uterus when pregnancy does not occur. The uterus normally prepares every month for the possibility of pregnancy but however, shed and bleed if pregnancy does not occur. Menstrual blood passes out through the vagina and is commonly called ‘a period’.
A normal menstrual cycle occurs every 28 days to 30 days of every month with duration of 2 to 7 days and average blood loss of about 2-8 tablespoons or can be gauged through pads used of about eight or soaked pads a day of no more than 2 days of heavy flow or bleeding.
The Menstrual cycle starts when the level of oestrogen rises and falls which usually happens at half way through the cycle to prepare the uterus by growing and thickening the lining of the uterus. During this time, the egg in one of the ovaries will start to mature. Matured eggs or ovum will start to leave the ovary on the 14th day of the 28 day cycle, which is termed as the ovulation period. If the ovum is met and fertilised by a sperm cell during sexual intercourse, it will attach itself to the uterine wall and the pregnancy cycle will start. In the event the ovum is not fertilized, the uterine wall will break and hormone levels will drop, the thickened lining will shed on the 28th day and start the menstrual period.
Menometrorrhagia Vs Menorrhagia
Menometrorrhagia is a prolonged uterine bleeding that occurs at irregular intervals and more frequently while menorrhagia is defined as heavy and prolonged period occurring at regular intervals and may be associated with dysmenorrhea.
Menorrhagia may be due to disruption of the hormonal regulation of the periods or may be due to underlying disorder of the endometrial lining of the uterus.
Regular cycle in period of patient with menorrhagia may cause enough blood loss and may hamper daily activities as brought by cramping and painful menstrual period. Blood loss in menorrhagia is greater than 80 ml or may last longer than 7 days. Menorrhagia occurs at regular intervals and is predictable unlike menometrorrhagia which is irregular in intervals and frequent in occurrence.
Symptoms of menometrorrhagia may include:
- Vaginal bleeding in between periods
- Menstrual cycle of less than 21 days
- Menstrual cycle of more than 35 days
- Menstrual period that lasts for more than 7 days
- Excessive bleeding that may soak up to 8 sanitary pads a day
- Large blood clots may be seen
- Presence of blood when urinating or wiping with sanitary tissue in between menstrual period
- Lower abdominal pain
- Back pain
Various causes may lead to menometrorrhagia which reproductive woman may suffer and these causes are:
- Hormonal Imbalance – this is due to an increase in the level of estrogen production outnumbering the progesterone level in a woman’s body. Hormonal imbalance may be a result of stress and birth control pills.
- Endometriosis – is a gynecological health condition characterized as growth of cells from the lining of the uterus outside the uterine cavity most commonly in the ovaries.
- Uterine Fibroids – a condition usually common for women of middle or late reproductive years and is the most common benign tumors that can be found within the uterine wall. Fibroids are tumor of the smooth muscle found in the uterine wall or may attach itself to the uterine wall.
- Dilation and Curettage – it is a diagnostic procedure that requires enlarging the opening of the uterus and scraping lining of the uterus to obtain tissue samples. It may also aid to stop the vaginal bleeding but only for a short period of time.
- Intrauterine Device or IUD – a form of birth control in T-shape plastic device placed in the uterus for the purpose of preventing pregnancy.
- Overweight or Obesity – excessive accumulation of fat in the body beyond the optimal healthy definition may cause menometrorrhagia.
Treatment for menometrorrhagia depends on the underlying cause and must first need to isolate malignancy prior to treatment course. Factors must also be included to identify the best treatment regimen to address the condition. The physician or OB Gynecologist must consider the overall health status of the patient, medical history, future plans of childbearing, tolerance to medications and therapies and must also include the understanding of the patient on her present condition.
Treatment may include:
- Dilation and Curettage – the procedure is done by opening the cervix and scraping tissues from the lining of the uterus to reduce bleeding of menstrual cycle.
- Oral Contraceptives – this treatment aside from birth control action also helps in regulating regular menstrual cycle and reducing prolonged menstrual period.
- Oral Progesterone – this drug treatment corrects hormonal imbalance when taken for 10 days or more of each menstrual cycle.