Menorrhagia

Patients with menorrhagia have regularly timed menstrual cyclees but the flow is either excessive in its duration (>7 days) or its volume (>80 mL/cycle). Patients with menorrhagia occasionally describe the blood as flooding or gushing, and may have blood clots along with their excessive flow. Most gynecologists use a history of greater than 24 menstrual pads in a day or soaking through a pad every hour as indicative of menorrhagia. Menorrhagia is most commonly caused by uterine fibroids, adenomyosis, endometrial polyps, and less commonly by endometrial polyps, and less commonly by endometrial hyperplasia or cancer or cervical polyps or cancer. Teenagers with menorrhagia should be evaluated for primary bleeding disorders such as von Willebrand disease, idiopathic thrombocytopenic purpura (ITP), platelet dysfunction, and thrombocytopenia from malignancy.