Metrorrhagia

What is Metrorrhagia? If you are experiencing heavy vaginal bleeding between menstrual periods, it is highly likely that you are suffering from so-called metrorrhagia. A condition in which a woman experiences irregular and excessive blood loss. This can occur between menstrual periods, during menses, or even after menopause, and can be caused by various factors. The bleeding may last only a few hours or up to 7 days. In some cases, it may be associated with polyps or other organic problems, but this is rare. Usually, metrorrhagia occurs due to a hormonal imbalance. In middle-aged and older women, metrorrhagia may be a sign of menopause and perimenopause. It is often confused with menstrual cycle irregularity. But because metrorrhagia can be a symptom of a serious disease, it should always be treated with special attention. Especially if it is accompanied by severe pain. Such bleeding can also cause anemia.
Causes
The causes of metrorrhagia, or intermenstrual bleeding, can vary. They depend, among other things, on age and health status. Among the most common are:
Before Puberty
Metrorrhagia is possible even before reaching sexual maturity. The average age for the onset of menstruation is 12.5 years. If vaginal bleeding is noticed earlier, there is cause for concern. The bleeding, for example, may be caused by the presence of a foreign body in the genital tract. In some cases, it may be an ulcer on the vulva. A more alarming cause is the possibility of a vaginal tumor. It can be the source of abnormal bleeding.
During or After Puberty:
•        Follicular Cyst. A follicle is a fluid-filled sac where an egg develops. When it grows abnormally and forms a kind of mass, it is called a follicular cyst. This anomaly disrupts the menstrual cycle because the release of the egg itself is compromised. This "malfunction" causes: metrorrhagia, frequent urges to urinate, and severe pelvic pain. In some women, follicular cysts also cause digestive disturbances by compression.
•        Endometrial Hyperplasia. This represents an abnormal proliferation of the cells present in the uterus. It should be noted that all types of cancer begin with the chaotic reproduction of cells. In fact, endometrial hyperplasia is a warning sign of possible uterine cancer. If not treated in a timely manner, this pathology can "develop" into an oncological condition. In addition to bleeding outside of menstruation, hyperplasia is also manifested by painful menstruation (dysmenorrhea).
•        Endometriosis. Endometriosis is a chronic disease that affects approximately one in 10 women. It is characterized by the formation of endometrial tissue outside the uterus due to migrating cells. These cells travel to other organs and create tissues similar to the endometrium. Since they are not in their proper place, they create lesions that lead to vaginal bleeding. In addition, endometriosis is associated with pain, including pelvic, abdominal, urinary, and even lumbar pain. Painful sensations are sudden and sometimes very intense.
In Pregnant Women.
Many women experience so-called breakthrough bleeding during pregnancy. In such a case, it is important to rule out ectopic pregnancy. Bleeding from a benign placental tumor is also possible. In the worst case, bleeding in a pregnant woman occurs as a result of a miscarriage.
After Menopause.
Menopause is a time when sex hormones are in "free fall". This is associated with amenorrhea and an increasingly long menstrual cycle. During this period, metrorrhagia is particularly concerning due to associated diseases.
•        Uterine Cancer (Endometrial/Cervical Cancer). One of the most frightening causes of breakthrough bleeding is uterine cancer. This is the formation of a tumor on the cervix (cervical cancer). In addition to being obviously a very serious disease, it is unfortunately quite common in women. According to studies, 500,000 new cases are registered annually. However, if detected early, uterine cancer is easily curable. Consequently, everything depends on timely diagnosis.
•        Uterine Fibroids (Leiomyoma). This condition, also called "fibromyoma," is common in women over 30. Although the exact causes are unknown, its manifestations are quite predictable: a feeling of coldness, constipation, or pain during sexual intercourse (dyspareunia). In many patients, fibroids cause, in addition to metrorrhagia, menorrhagia (very heavy bleeding during menstruation).
Emergency Contraception.
This type of contraception, such as special pills, can cause bleeding.
Hormonal Contraceptives.
This type of contraceptive is the most common cause of vaginal bleeding between menstrual periods. These include:
•        Intrauterine device (IUD).
•        Contraceptive pill.
•        Contraceptive patch.
•        Vaginal ring.
•        Contraceptive implant.
Sexually Transmitted Infections (STIs).
Some sexually transmitted diseases can cause vaginal bleeding.
Cervicitis.
This is an inflammation of the cervix, which usually manifests, among other symptoms, with bleeding.
Hypothyroidism.
Low thyroid performance or complications associated with it can cause uterine bleeding.
Lesions at the Vaginal Introitus: They can also manifest as bleeding.
Types of Metrorrhagia
Metrorrhagia is subdivided into two types depending on its origin.
•        Bleeding of Organic Origin. These include those related to pregnancy and those that are unrelated. In the second case, the most common causes are the presence of polyps, fibroids, or cysts. In addition, they can sometimes be a sign of thyroid problems or serious liver or kidney complications.
•        Bleeding of Non-pathological Origin. This is the so-called dysfunctional uterine bleeding (DUB), which is abnormal bleeding outside of pregnancy or without any underlying disease, occurring due to a hormonal imbalance that damages the endometrium.
Symptoms
Symptoms of abnormal uterine bleeding due to ovulatory dysfunction may include menstrual cycle irregularity, where periods may be shorter or longer than the usual 7-day menses, as well as heavier and more frequent than usual. In some cases, menorrhagia (heavy menstrual bleeding) and metrorrhagia (frequent, but light intermenstrual bleeding) are also signs of the condition. Here are the signs to watch out for:
•        Symptoms of anemia: rapid fatigue, shortness of breath (dyspnea).
•        Need to use double sanitary protection to control menstrual flow.
•        Bleeding lasting more than a week.
•        Passage of large clots.
If left untreated, metrorrhagia can lead to serious complications such as hemorrhage, anemia, and even endometrial cancer. It is important to seek medical attention if you experience any of these symptoms, as early diagnosis and treatment are essential to prevent serious consequences.
Diagnosis of Metrorrhagia
If bleeding occurs more than once or if it is accompanied by pain or other symptoms, it is important to visit your gynecologist for further examination. The doctor may request tests such as:
•        Gynecological examination or hysteroscopy to examine the inside of the uterus and cervix.
•        Ultrasound (US) or Magnetic Resonance Imaging (MRI).
•        Laboratory tests to determine the underlying cause of the bleeding.
•        Endometrial biopsy.
The gynecologist usually starts with a blood test to check hormone levels and rule out hormonal causes. The doctor may then recommend an ultrasound to identify organic causes such as fibroids or polyps. Depending on the test results, further treatment may be necessary. Hormone levels can also be checked during the diagnosis and treatment of metrorrhagia. If hormone levels are not normal, your doctor may prescribe medications or suggest lifestyle changes that can help regulate them and reduce the number of bleeding episodes.
Treatment Methods
In some cases, metrorrhagia may indicate a medical problem that requires treatment. Common treatment methods for metrorrhagia include:
•        Use of oral contraceptives to regulate the menstrual cycle.
•        Hormone therapy to increase estrogen and progesterone levels.
•        Non-steroidal drugs, such as ibuprofen, to reduce uterine inflammation.
•        Tranexamic acid to reduce menstrual blood loss during bleeding.
Additional treatment may be required if a polyp, cyst, miscarriage, ectopic pregnancy, or anemia is present. In any case, your gynecologist will recommend that you monitor your menstrual cycles, as well as the frequency and duration of bleeding episodes, as this can help doctors diagnose any underlying problems and provide the best treatment. Menopause can also be a factor in metrorrhagia due to a decrease in estrogen levels; however, treatment after menopause is usually hormone therapy, as medications are not as effective. Surgical intervention may also be necessary if a tumor is present.
Common Questions About Metrorrhagia
How serious is metrorrhagia? Metrorrhagia is a sufficiently serious condition, as it is characterized by the presence of abnormal uterine bleeding outside the menstrual period. It can be a symptom of a number of diseases such as uterine cancer, endometriosis, and uterine fibroids, and in a number of cases is accompanied by pain and other symptoms. It is important to see a doctor to conduct the appropriate tests and rule out any pathology that may be causing the bleeding. Similarly, you should seek help if the bleeding is excessively heavy or if you experience intense pain during menstruation. In any case, it is recommended to remain vigilant for any changes in the amount or regularity of menstrual flow, as well as any other previously unknown symptoms.
What to do in case of metrorrhagia? If the bleeding is severe and cannot be stopped with sanitary pads, you should call for emergency medical help. The doctor will assess the cause of the bleeding and decide whether any additional tests are needed, such as ultrasound, hormonal analysis, etc., and also prescribe the most appropriate treatment to stop the bleeding. If necessary, the patient will be hospitalized.
How long can metrorrhagia last? The duration varies depending on the case; it can range from a few days to several weeks. If metrorrhagia is mild, it usually does not last long. In addition, treatment prescribed by a doctor can help relieve symptoms and shorten the duration of metrorrhagia.
What causes metrorrhagia? Common hormonal disorders causing metrorrhagia are ectopic pregnancy, decreased estrogen levels after menopause, and polycystic ovary syndrome (PCOS). Other common medical problems that can cause metrorrhagia include uterine infections, endometriosis, uterine fibroids, and trauma to the uterus or other nearby tissues. Metrorrhagia can also be caused by medications such as oral contraceptives or hormone replacement therapy. Incorrect medication intake can also cause abnormal spotting and vaginal discharge.