Metrorrhagia

Definition

Metrorrhagia is a loss of uterine blood that is outside normal blood loss related to the menstrual cycle; in fact, in fact, it occurs in the intermenstrual period. When metrorrhagia appears during menstruation, it is called menorrhagia (the result is abundant blood loss); if instead the flow, besides being abundant, continues even in the intermenstrual phase we speak more correctly about menometrorrhagia .

Metrorrhagia during puberty

Despite the metrorrhagia mainly affects women of childbearing age, there are cases in puberty and in the post-menopausal period. Some sporadic metrorrhagic manifestations during childhood have also been noted, mostly associated with other diseases; in the so-called precocious puberty, the child becomes a woman in advance. In the new woman, sexual development is premature and manifests itself with growth of the breast, development of the genital organs, growth of pubic and axillary hair, appearance of menstruation and expansion of the uterus in terms of volume: all these factors are related to a hormonal modulation and may reflect a possible endocrine imbalance. In this phase, all the metabolic-physiological processes must be speeded up within the body: in this regard, often the regulation systems go haywire, causing phenomena such as, for example, changes in the menstrual cycle, menorrhagia, dysmenorrhea and metrorrhagia. It is good to remember that during the appearance of the first menstruation - which coincides with the period of transformation from child to woman - it is difficult to distinguish the metrorrhagia from the menorrhagia, since the menstrual cycle must still stabilize, so much so that, more often than not, it is not even possible to distinguish menstruation itself from extra-menstrual bleeding.

Metrorrhagia in adult women

Generally, the most serious causes of metrorrhagia in adult women are found in uterine tumors (eg fibroids, benign mucous polyps, malignant neoplasms) and in acute inflammation of the endometrium.

Sometimes, the abundant genital blood loss is a sign of spontaneous abortion: it has been verified that some women, especially during the first pregnancy, experience a miscarriage after a few weeks from conception, of which metrorrhagia is the first alarm bell.

In other cases the metrorrhagia could present a less "dangerous" etiological picture: similarly to menorrhagia, metrorrhagia may also be the "simple" result of transient hormonal alterations. It is no coincidence, for example, that in the first three months of taking the contraceptive pill - a moment of strong endocrine imbalance - the woman complains of sudden and unexpected uterine bleeding between one menstruation and another. If the history of intermenstrual blood loss continues even after the first three months of treatment, metrorrhagia probably depends on other factors.

Obviously, the introduction of foreign bodies into the vagina could also cause uncontrolled bleeding.

Therefore, in general, local organic factors (in particular submucosal and intramural fibroids, uterine inflammation, cervical polyps, malignant tumors) and general (modification of blood coagulation, cardiac pathologies, infections and heavy metal poisoning), associated with functional alterations of regulation of the menstrual cycle, they are the most frequent causes that contribute to the appearance of metrorrhagia in adult women.

Metrorrhagia in menopause

We have analyzed the first two phases of a woman's life (puberty and adulthood): however, we have mentioned that metrorrhagia can also appear shortly before and during menopause, a period in which the woman is no longer fertile. In the case in which the woman manifests metrorrhagia in the phase preceding the menopause (climacteric), the aforesaid condition can be considered pseudo-physiological; in this period of life, the organism is in fact subjected to a strong hormonal modulation in preparation for the menopause, so that intermenstrual losses can generally be considered physiological and separated from particular problems.

If the metrorrhagia occurs even during menopause, this unexpected and abundant blood loss can no longer be considered physiological: in general, metrorrhagia in menopause is in fact a sign of rather serious pathologies (cervical cancer and uterine carcinoma). Precisely because in menopause the metrorrhagia could prove to be very serious, it would therefore be appropriate to contact the gynecologist as soon as possible, given that an immediate diagnosis and prompt treatment guarantee, most of the times, positive therapeutic implications.

Effects and treatments

In all stages of the female's life, with particular reference to puberty, adulthood and menopause, frequent metrorrhagia could cause alterations in the concentration of iron in the blood, giving rise to situations of secondary (ie induced) anemia: in similar circumstances, the gynecologist can recommend iron supplementation to remedy deficiencies. In the most serious cases, in which the woman complains of excessive blood loss, transfusions could be used to remedy the consequences deriving from severe metrorrhagia.

If the cause causing the metrorrhagia is represented by the hormonal alteration, the patient, after prescription, could take hormones to rebalance the estrogenic structure.

Summary

To fix the concepts ...