1 / 11

Management of Abnormal Vaginal Bleeding

Management of Abnormal Vaginal Bleeding. D.W Polson Consultant Obstetrician & Gynaecologist. Management of Abnormal Vaginal Bleeding. What is Normal? What is Abnormal? Age – Related Management Discussion. Normal Menstrual Cycle. Bleeding 5 Days Menstrual cycle 28 days

leal
Télécharger la présentation

Management of Abnormal Vaginal Bleeding

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Management of Abnormal Vaginal Bleeding D.W Polson Consultant Obstetrician & Gynaecologist

  2. Management of Abnormal Vaginal Bleeding • What is Normal? • What is Abnormal? • Age – Related Management • Discussion

  3. Normal Menstrual Cycle • Bleeding 5 Days • Menstrual cycle 28 days • No other bleeding • Dependent on normal cyclical ovarian function

  4. What is Normal? • Duration 2-7 days • Cycle length 22-35 days • Number of pads used 3 – 9 • Mid-cycle spotting - common

  5. Problems in Teenagers • Irregular periods • Menorrhagia / dysmenorrhoea • Investigations –None • Management – Combined Pill

  6. Problems in 20-30 year olds • Not Common • Iatrogenic IMB /PCB whilst taking the combined pill • Menorrhagia • Investigations – Pelvic ultrasound for endometrial thickness

  7. Problems in 30 – 40 year olds • Menorrhagia – more common • Examination ? Fibroids • Investigations – FBC - Ultrasound • Management – O C Pill - medical - surgical

  8. Problems in 40 – 50 year olds • Increasingly more common • Menorrhagia / I.M.B / Irregular cycle • Investigations – FBC - Day 2 FSH / Oestradiol - Ultrasound - ? endometrial biopsy • Management – o c pill - Norethisterone - medical - surgical

  9. Problems in the > 50’s • Post menopausal bleeding • Examination and pelvic ultrasound • Endometrial thickness – biopsy if indicated • Management – Topical oestrogen - surgery

  10. Medical Management of Menorrhagia • Weight reduction • Combined pill • Mefenamic Acid • Tranexamic Acid – 1gm tds • Norethisterone – D5-25 • Mirena – IUS • GnRH agonist therapy

  11. Summary • Abnormal vaginal bleeding is a common problem • Usually related to ovulatory dysfunction and not malignancy • Medical management usually successful • Mirena and MEA now effective alternatives to hysterectomy

More Related