1 / 5

Menorrhagia

Menorrhagia. F.S. 42yr Female HPC Menorrhagia with clots Cycle 5 / 31 Mild dysmenorrhoea O/E Non-bulky uterus Cervix nad. Heavy Cyclical Menstrual Blood Loss. Symptoms Suggestive of Other Pathology: Intermenstrual bleeding Postcoital Bleeding Dyspareunia Pelvic Pain

Jimmy
Download Presentation

Menorrhagia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Menorrhagia F.S. 42yr Female HPC • Menorrhagia with clots • Cycle 5/31 • Mild dysmenorrhoea O/E • Non-bulky uterus • Cervix nad

  2. Heavy Cyclical Menstrual Blood Loss • Symptoms Suggestive of Other Pathology: • Intermenstrual bleeding • Postcoital Bleeding • Dyspareunia • Pelvic Pain • Risk Factors for Endometrial Cancer • Tamoxifen • Unopposed Oestrogen Tx • PCOS • Obesity Hx: • Exam: • Abdo. • Bi-manual VE • Swab, +/- smear Normal or Bulky Uterus <10wks Uterus >10 weeks,Pelvic Mass,Tenderness FBC Triple swab Inv.: Tx in 1ry Care Consider Referral

  3. F.S. 42yr Female HPC • Menorrhagia with clots • Cycle 5/31 • mild dysmenorrhea • No I/M or Post-coital Bleeding • No Dyspareunia,Pelvic Pain PMH • Hypothyroidism on thyroxine • Cervical smear -Ve O/E • not obese • Non-bulky uterus

  4. Hb N’l & Patient Does NOT want Tx Hb Low or Patient Requests Tx Reassurance Patient does Not require Contraception Patient requires Contraception Tranexamic acid 1g tds &/or Mefenamic acid 500mg tds starting on the 1st day of period for heaviest days of flow Mirena Coil Long-acting Progestogens Combined OCP No control flow after 3/12 No control flow after 3/12 or side effects Add Mefenamic acid No control flow after 6/12 No control flow after 3/12 referral Referral referral

  5. Inv. Hb n’l TFT’s n’l Triple swab –Ve Mx. 12/3/01 -tranexamic acid 25/4/01 unable to tolerate,still menorrhagia -Fbc -U.S. Pelvis -COCP Microgynon 30 26/4/01 anaemia -oral FeSO4 15/5/01 U.S. Nad menorrhagia -referral BWH for pipelle BWH pipelle nad Dx. Func. Uterine Bleeding 20/7/01 -talked about Dx. And Mirena -COCP Loestrin 30 -Fbc 27/9/01 Hb 12 Fe studies 5/10/01 FE studies n’l -off oral FeSO4 Reg check TFT’s always n’l or slightly low with dose change thyroxine 2/7/04 menorrhagia repeat protocol W/U Nad talked about Mirena 19/7/04 Mirena fitted d/w patient pros/cons No Further Consults re This Issue to-date

More Related