| ID | 309 |
|---|---|
| Name | MENORRHAGIA |
| Cause | Causes: 1. Ovarian cause- granulosa cell tumour. 2 Fallopian tube- salphingitis, salphingo-oophoritis. 3. Uterine cause- i. Enlargement of surface area of endometrium as in- a. Uterine fibroid. b. Congenital large uterus. c. Uterine polyp. d. Ca. uterus, ii. Endometritis. iii. Adenomyosis. 4. Hormonal- i. Hypothyroidism. ii. Hyper thyroidism. 5. Mechanical-i. IUCD. 6. Faulty clotting- i. Leukemia, ii. Hypofibrinogenemia. 7. General- i. Hypertension. ii. Cirrhosis of liver. iii. Anxiety and tension. iv. Acute pyrexia due to any cause. |
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| Introduction | Cyclical heavy and prolonged menstrual loss at normal interval, for example 4/28 or 8/28 days. |
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| Types | Types: 1. Irregular rippening. 2. Irregular shedding. Irregular rippening: Due to poor formation and function of corpus luteum causing incomplete secretory changes in the endometrium. Symptoms: A patient with a previous regular cycle start bleeding usually at 14th day and continue upto next menstruation. This type of bleeding also found in cases of cervical erosion or polyp and break through bleeding of contraceptive pills. Investigation: Histopathology of the curettage shows patchy progesteronal changes or secretory phase. Irregular shedding: Persistent and overactivity of corpus luteum causing persistance of secretory changes in the proliferative phase. Clinical features: After proper flow the pt. complains of slight intermittent bleeding for several days. Investigation: Histopathology of curettage on proliferative phase shows persistent of patchy secretory changes. EPIMENORRHOEA It is a cyclical bleeding of normal amount but which occurs at too frequent interval, for example 4/21 days. No organic cause has been found. Causes: Here the ovary goes more frequently in function due to-1 Disturbance of pituitary overian relationship. 2. Congestion of overy with vasomotor disturbance. 3. Endometriosis in the overy. EPIMENORRHAGIA Cyclical bleeding which is both excessive and too frequent, for example 8/21 days. Causes: It implies the disturbance in both ovary & uterus, others are pelvic congestion, infection and anxiety. |
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