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Menometrorrhagia is a condition in which prolonged or excessive uterine bleeding occurs irregularly and more frequently than normal. It is thus a combination of irregular menstruation and menorrhagia.

Epidemiology

It occurs in up to 24% of women ages 40-55 years.^[1]

Causes

It can occur due to any of several causes, including hormonal imbalance, endometriosis, uterine fibroids, usage of progestin-only contraception, or cancer.^[2] It can lead to anemia in long-standing cases.

Workup

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.^[1]

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.^[2]

References

^ ^a ^b Donnez, J. (2011). "Menometrorrhagia during the premenopause: An overview". Gynecological Endocrinology 27: 1114–1119. doi:10.3109/09513590.2012.637341. PMID 22182054. edit
^ ^a ^b Bouchard, Philippe (December 2011). "Current and future medical treatments for menometrorrhagia during the premenopause". Gynecological Endocrinology 27 (Supplement 1): 1120–1125. doi:10.3109/09513590.2012.638754. ISSN 0951-3590. PMID 22182055.

UpToDate Contents

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1. 妊娠していない生殖可能年齢の女性における不正子宮出血に対するアプローチ approach to abnormal uterine bleeding in nonpregnant reproductive age women
2. 異常な子宮出血のマネージメント management of abnormal uterine bleeding
3. 重度または持続性子宮出血のマネージメント managing an episode of severe or prolonged uterine bleeding
4. 出血性素因を有する成人患者へのアプローチ approach to the adult patient with a bleeding diathesis
5. 思春期における異常子宮出血：鑑別診断およびアプローチ abnormal uterine bleeding in adolescents differential diagnosis and approach

English Journal

Effect of myrtle fruit syrup on abnormal uterine bleeding: a randomized double-blind, placebo-controlled pilot study.

Qaraaty M, Kamali SH1, Dabaghian FH, Zafarghandi N, Mokaberinejad R, Mobli M, Amin G, Naseri M, Kamalinejad M, Amin M, Ghaseminejad A, HosseiniKhabiri SJ, Talei D.
Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences.Daru.2014 Jun 2;22:45. doi: 10.1186/2008-2231-22-45.
BACKGROUND: Myrtle (Myrtus communis L.) has been used in the Iranian Traditional Medicine as a treatment for abnormal uterine bleeding-menometrorrhagia. The main aim of this study is to evaluate the effect of myrtle fruit syrup on abnormal uterine bleeding-menometrorrhagia.METHODS: A randomized, dou
PMID 24888316

Incidentally discovered uterine sarcoma in a premenopausal patient after hysterectomy for postembolization endometritis.

Chu EC1, Santos E, McCluskey K.
Cardiovascular and interventional radiology.Cardiovasc Intervent Radiol.2014 Jun;37(3):839-42. doi: 10.1007/s00270-013-0805-x. Epub 2013 Dec 6.
Uterine leiomyomas (fibroids) are the most common benign tumor of the female reproductive system. Fibroids can become symptomatic with symptoms such as menorrhagia and menometrorrhagia, pelvic pain, and reproductive dysfunction. Hysterectomy, myomectomy, and the less invasive uterine artery emboliza
PMID 24310827

Endometrial carcinoma in a 15-year-old obese patient with persistent uterine bleeding.

Liu G1, Wang Y, Zhang X, Yuan B, Han C, Xue F.
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology.Gynecol Endocrinol.2014 Apr;30(4):277-9. doi: 10.3109/09513590.2013.875156. Epub 2014 Jan 23.
Endometrial carcinoma is the most common malignancy of the upper female genital tract but is rare in teenagers. Here, we report the case of a 15-year-old, nulliparous, morbidly obese female with complaints of asthenia and menometrorrhagia lasting for six months. On examination, the patient had an en
PMID 24456540

Japanese Journal

中間期出血への関与が考えられる子宮内膜ポリープ

万歳稔,生田克夫
日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology 24(2), 379-382, 2008-12-01
… Objective: Minor bleeding that occurs for several days around ovulation is called intermenstrual or ovulation bleeding, and is classified as a type of menometrorrhagia with no organic abnormalities. …
NAID 10025692561

Relaxin stimulates expression of vascular endothelial growth factor in normal human endometrial cells in vitro and is associated with menometrorrhagia in women