This week (after a very long break) we get back to business. We’ll take you through the diagnosis, management and investigation of acute menorrhagia.
Take Home Messages:
- Acute Menorrhagia can be severe enough to create haemodynamic instability, assess for shock first.
- Always perform a B-hCG to exclude pregnancy/miscarriage
- Be sure to exclude a pelvic infection in your work-up
- Consider inherited platelet dysfunction or coagulopathies in the adolescent with new menorrhagia
- Consider endometrial hyperplasia or cancer in the woman over 35
- Medical management may include NSAIDs, high-dose Progesterone, Tranexamic Acid
- Surgical management may include Dilation & Curettage
References & Resources:
Adolescent Gynaecology – Menorrhagia Clinical Practice Guidelines, Royal Children’s Hospital Melbourne (Australia)
Menorrhagia (PDF) Australian Doctor Magazine ‘How To Treat’ (2009)
Heavy Menstrual Bleeding NICE Guideline UK (2007, updated 2013)