Menometrorrhagia is a condition in which prolonged or excessive uterine bleeding occurs irregularly and more frequently than normal. It is thus a combination of metrorrhagia and menorrhagia.
Menometrorrhagia means excessive uterine bleeding, both at the usual time of menstrual periods and at other irregular intervals. Menometrorrhagia can be a sign of a number of different disorders including hormone imbalance, endometriosis, benign fibroid tumors in the uterus, and, rarely, cancer.
Menometrorrhagia is a condition marked by abnormally heavy, prolonged, and irregular uterine bleeding. Women with this condition usually bleed more than 80 ml, or 3 ounces, during a menstrual cycle. The bleeding is also unexpected and frequent. For example, you’ll likely experience bleeding outside of when you’d expect your menstrual period to occur.
Types of Menometrorrhagia
Menometrorrhagia is actually a combination of two menstrual disorders:
- menorrhagia, which is heavy uterine bleeding that occurs at regular intervals
- metrorrhagia, which is irregular bleeding
It’s important to seek medical help if you’re experiencing menstrual irregularity. Unexpected or abnormal menstrual bleeding can have health consequences that shouldn’t be ignored.
Causes of Menometrorrhagia
It can occur due to any of several causes, including hormonal imbalance, endometriosis, uterine fibroids, usage of progestin-only contraception, or cancer.[rx] Not least, it can be caused by deficiencies of several clotting factors. It can lead to anemia in long-standing cases.
- A hormonal imbalance – Having too much of the female hormone estrogen can cause the uterine lining to grow thicker than expected. When that thicker lining begins to shed, it can lead to increased blood loss and clots. An estrogen imbalance can occur for a variety of reasons, including stress and obesity.
- Uterine growths – Tumors, such as uterine polyps and fibroids, can cause excessive bleeding due to the pressure they place on the uterus, as well as the blood vessels these growths contain. These types of tumors are usually benign, or noncancerous.
- Adenomyosis – This is a condition in which the uterine lining grows into the muscular wall of the uterus. It acts as the normal uterine lining does, growing and shedding each month, but it can produce heavy bleeding. The cause of adenomyosis isn’t well known, but it’s often seen in women who have reached menopause.
- Endometriosis – Endometriosis occurs when the uterine lining grows outside the uterus, usually in the fallopian tubes, ovaries, and pelvis. When this lining sheds, the bleeding can be substantial.
- Lack of ovulation – Ovulation refers to the release of an egg from the ovary. If you don’t ovulate, or have what’s known as an anovulatory cycle, the uterine lining can continue to grow until it’s forced to shed.
- Blood clotting disorders – When blood cannot coagulate properly, bleeding is more prolonged.
Symptoms of Menometrorrhagia
There’s no concrete medical definition of “abnormal” uterine bleeding. For the average woman, menstruation occurs every 28 days, though having a period every 21-35 days is considered normal. The average length of a menstrual cycle is about 5 days. Most women will lose less than 80 ml, or 3 ounces, of blood overall.
Most experts agree that any bleeding that’s so excessive and severe that it interferes with your physical, social, and emotional life is abnormal. Some clues your bleeding is out of the ordinary and you might be experiencing menometrorrhagia include:
- soaking through tampons or sanitary pads every hour for several hours
- bleeding longer than eight days
- bleeding outside your usual menstrual cycle
- passing large blood clots
- having back and abdominal pain during menstruation
- feeling tired, weak, or short of breath, which may be signs that the excessive bleeding has reduced the amount of iron in your blood, leading to anemia
Diagnosis
The initial workup includes exclusion of pregnancy and cancer, by performing a pregnancy test, a pelvic exam and a gynecologic ultrasound. Further workup depends on outcomes of the preceding tests and may include hydrosonography, hysteroscopy, endometrial biopsy, and magnetic resonance imaging.[rx]
Treatment
Treatment depends on the cause. In cases where malignancy is ruled out, hormone supplementation or the therapeutic use of hormonal contraception is usually recommended to induce bleeding on a regular schedule. Selective progesterone receptor modulators (SPRMs) are sometimes used to stop uterine bleeding.[1]
- Birth control pills – to regulate hormone levels.
- Progestin therapy – Progestin is a synthetic version of the naturally occurring hormone progesterone. Your doctor my recommend taking progestin in the form of a pill for 21 consecutive days and then stop for 7 or using a levonorgestrel-releasing intrauterine device (IUD). Levonorgestrel is also a progestin. Progestin helps thin the uterine lining and thus reduce menstrual blood flow.
- Nonsteroidal anti-inflammatories (NSAIDs) – Besides relieving the pain associated with menometrorrhagia, these drugs help to coagulate blood and limit its flow.
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