Menometrorrhagia is excessive uterine bleeding, both when you would normally have your period and in between your periods. It's a combination of two different conditions: menorrhagia, which is heavy bleeding during your period, and metrorrhagia, which is when your period lasts more than seven days or you have spotting between periods.
However, doctors prefer the term "abnormal uterine bleeding" now because abnormal bleeding is a symptom that can be caused by many different conditions. It's a common condition that affects between 10 and 30% of women of childbearing age.
In fact, abnormal uterine bleeding is the most common menstrual disorder among premenopausal women. It is not always serious, but it can have serious underlying causes, so it's important to see your doctor if you're having problems with heavy menstrual bleeding.
What Are the Symptoms of Menometrorrhagia?
The symptoms of abnormal uterine bleeding will vary depending on the cause but may include:
- Heavy bleeding during your period
- Periods that last longer than normal
- Irregular menstrual cycles
- Bleeding that occurs at unusual times such as between periods or after sex
What Causes Menometrorrhagia?
There are numerous conditions that can cause abnormal uterine bleeding. Some of these include:
Fertility and reproductive issues.
- Fluctuating hormone levels
- Ectopic pregnancy
- Vaginal atrophy
- Random ovulatory cycles
Endocrine system issues.
- Polycystic ovarian syndrome (PCOS)
- Changing or stopping hormonal birth control or therapy
Cancer or precancerous conditions
- Endometrial cancer (uterine cancer)
- Endometrial hyperplasia, which is a thickening of the uterus's lining
- Vaginal cancer
- Ovarian cancer
- Cervical cancer
- Uterine sarcoma
- Systemic diseases like kidney or liver disease
- Celiac disease
- Blood clotting disorders
- Low platelet count
Other uterine conditions.
Trauma. A penetrating or blunt injury to the vagina or cervix or sexual abuse can cause abnormal uterine bleeding.
How Is Menometrorrhagia Diagnosed?
Your healthcare provider will talk to you about your symptoms, including how long you have had them. They will also do a physical exam including a pelvic exam, a cervical exam, and a Pap smear. Depending on your health history and exam results, you may need other tests, which could include:
- Thyroid test
- Pregnancy test
- Hormone levels
- Hysteroscopic exam to check the lining of your uterus for fibroids, polyps, or cancer
- Pelvic ultrasound
- Biopsy of the endometrium
How Is Menometrorrhagia Treated?
The treatment for menometrorrhagia will depend on the cause and on whether you want to become pregnant in the future. Most doctors will start with medical management if they don't suspect you have a bleeding disorder. Some medical options for treatment include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). Medicines such as ibuprofen or naproxen sodium help reduce blood loss during your period. They can also help with painful cramps.
Birth control pills. Oral contraceptives can help regulate your menstrual cycles and reduce heavy or prolonged bleeding.
Progesterone. This hormone may be used to correct a hormone imbalance and reduce heavy bleeding.
Tranexamic acid. This medicine helps reduce menstrual bleeding. The brand name is Lysteda, and it only needs to be taken when you are bleeding.
Hormonal intrauterine device (IUD). IUDs release a type of progestin called levonorgestrel. This makes the uterine lining thin and decreases menstrual blood flow and cramping.
Stopping or changing hormonal medicine. If your hormone medicine causes abnormal uterine bleeding, your doctor may change or stop your hormone treatment.
Iron supplementation. If you have anemia, which is a low iron level, or iron levels that are low but not yet anemic, your doctor may suggest that you take iron supplements.
Some causes of menometrorrhagia are best treated with surgery. Depending on the underlying cause, surgical options may include:
Uterine fibroid embolization. This surgery gets rid of fibroids by cutting off their blood supply. Tiny particles are put into the uterine arteries. This causes the fibroids to shrink.
Myomectomy. This surgery gets rid of the fibroids but keeps the uterus intact. Women can still become pregnant naturally after this procedure.
Uterine ablation. For women who do not want to become pregnant in the future, uterine ablation may be the best option. In this surgery, the lining of the uterus is destroyed. This can be done with laser, heat, electricity, microwave energy, or freezing.
Hysterectomy. If hormone treatment fails to control abnormal uterine bleeding, your doctor may suggest removing your uterus as a last resort. A hysterectomy may also be necessary if cancer is the cause of your menometrorrhagia. This may be followed by radiation or chemotherapy.