MENSTRUAL DISORDER MANAGEMENT

Abnormal uterine bleeding (AUB) is a common condition affecting about 14-25% of females it is characterised by prolonged heavy bleeding .Normally a female bleeds for about 2-7 days in 21-35 days and loses about 5-80ml of blood during one menstrual cycle. Any bleeding which is severe and affects daily activities is not normal and this abnormal characteristic of menstrual bleeding is AUB.

Federation of gynecologist and obstetrician (FIGO) has coined PALM COEIN for classification of AUB where

P – Polyp
A – Adenomyosis
L – Leiomyoma (Fibroid)
M – Malignancy
C – Coagulopathy
O – Ovulatory Dysfunction
E – Endometrial Dysfunction
I – Iatrogenic
N – Not yet classified

Management Of AUB

A specific treatment plan is chalked out based on factors like age , severity of the problem , possible cause of the condition.

Teenage group -Menses at menarche are generally irregular and they would settle down being regular in some time, but bleeding disorders, infection, and pregnancy complications in sexually active females are to be ruled out. PCOS is being the most common cause in teenagers.
Reproductive age group – pregnancy is to be ruled out and the female is investigated by doing an

Ultrasound

Blood tests which include thyroid profile and serum prolactin levels. Bleeding disorders and infections are to be ruled out. Thyroid dysfunction raises prolactin levels,

laparoscopy -to see if Fibroids, polyps, adenomyosis, endometriosis, ovarian dysfunction are common causes in this age group.
hysteroscopy
Females > 45 years of age,

Cancers could be a cause for AUB.

Biopsy -Endometrial and cervical biopsy is recommended to rule out endometrial cancer or cervical cancer.

Cervical cancers are very common in India.
At our clinic, we perform a thorough physical examination, and a cervical biopsy is taken, if needed.

Here at Renew, we follow these worldwide accepted criteria.

Further treatment is provided as per the results of the tests. Anti-thyroid medications are started if the thyroid profile is abnormal.

(Tranexamic acid, NSAIDs,)

Oral contraceptive pills

Hormonal supplements like oral progesterone, other oral medications or injections,

Insertion of an intrauterine device called LNG-IUS,

Surgery-Hysteroscopy, Hysterectomy and Endometrial biopsy if needed,

Females having cancers may require chemotherapy or radiotherapy.