The Causes of Menorrhagia And Classifications

Although difficult to diagnose, document, heavy menstrual bleeding still represents a high-risk, compulsive, and contagious disease.

Much of this can happen at a time when the impact of education, productivity, or family relationships can have lifelong consequences. That is why the American College of Obstetricians and Gynecologists recommends that menstruation be considered a “significant sign.”

Menstrual cramps, severe menstrual cramps are classified as primary or secondary, depending on the clinical features associated with anemia. Severe menstruation Recently, there has been an extensive grading program that includes many types of menstrual irregularities: the PALM-COEIN system.

There are many parallels between the old and the new classification system, but the key is to identify the cause whenever possible. In the process, the intervention will be more effective in preventing or improving symptoms.

What is the Causes of Menorrhagia?

Menorrhagia can be caused by a problem with the uterus, hormonal problems, or other illnesses. Other reasons include:

  • Non-cancerous uterine growths or tumors
  • Cervical cancer
  • Certain types of contraceptives
  • Problems related to pregnancy (miscarriage or ectopic pregnancy, when the fertilized egg implants outside the uterus)
  • Bleeding problems
  • Diseases of the liver, kidneys, or thyroid gland.
  • Pelvic inflammatory disease (and female genital infections)
  • Take certain medications, such as aspirin
  • Menopause, also called perimenopause
  • Birth
  • Fibroids or polyps in the lining of the uterus or muscle

Menorrhagia & Classifications

Causes of Menorrhagia & Classifications –

Because menstrual overflow can be considered part of a “normal or severe” ongoing flow, specific location patterns or diagnoses are often behind or along with dysmenorrhea.

In some cases, severe menstrual flow has been discussed several times as a result of specific diseases, but not as a result of various diagnostic tests.

Cold and appendicitis are common, both of which can cause fever, but they do not know what causes the disease when the patient has a fever. In serious male complaints, this was unfortunately common.

This left the doctor with few tools or structures to diagnose possible diseases. To fill this gap, authors who recommend direct menstrual bleeding should also consult the patient’s report (which is not reliable), but “because it provides more clues from the test results. Blood can actually help in the diagnosis.

In addition to blood volume, there is confusion with color, consistency, coagulation, and other tissues and substances. ”The clinician, reflecting the current gender distribution, identifies as male.

The causes of Menorrhagia symptoms are often due to speculation or widespread medical spread.

For example, in the late 1800s, there was a large part of the role of medical fire, which is why a large menstrual flow was associated with pelvic inflammatory disease. “There may also be constant accumulation, coagulation and other displacements in the uterus, tumors, cervical spondylosis, diseases of other organs and plants”.

“It can also be intense joy, fear, or a bad cold; it can be responsible for the bleeding.” The authors then classify them as organic, endocrinological, anatomical, and aerodynamic causes or according to the role of the hypothalamic-pituitary-ovarian axis.

Due to large menstrual bleeding and large menstrual flows, the most common grade of monthly bleeding became primary and secondary, defined as dysmenorrhea, based on the presence or absence of a clinically identified pathology.

Until 2011, the International Federation of Obstetricians and Gynecologists (FIGO) introduced a comprehensive classification system for menstrual irregularities, abbreviated “PALM-COEIN”.

This classification system classifies old and well-defined terms and patterns of bleeding disorder uterus as well as emotionally. The classification of factors bears many similarities to the primary and secondary “structural” and “structural” classifications.

The FIGO system is ideal for describing the rhythm or duration of menstruation. The system generally results in “cervical hemorrhage” without clinical onset (primary anemia), described as “Oval / HMB-O” or “endometrium” (AUB / HMB-E).

Causes of Menorrhagia

However, for the process of prostaglandin through the endometrium, which normally occurs in normal ovarian function and endometrial histology, FIGO is a physiological indicator of discussions of severe bleeding in the menstrual system.

Although the FIGO system is supported by the American University of Obstetricians and Gynecologists, the PALM-COEIN system offers little understanding or variability.

For example, ovarian dysfunction does not increase normal menopause, and although PALM-COEIN diagrams generally include all menstrual irregularities, they are generally excluded from the AUB / HMB label, known by the acronym PALM-COEIN.

This classification system classifies old and well-defined terms and patterns of bleeding disorder uterus as well as emotionally. The classification of factors is similar to the “structural” and “structural” classifications of primary and secondary education. To include them.

The system does not differentiate between endometrial hyperplasia and endometrial cancer, both under AUB-M. The risk of pregnancy, sometimes described as severe vaginal bleeding, is not included in the FIGO classification, although it is considered “menstrual bleeding.”

For this reason, the concept of primary and secondary, distinctive and mysterious causes of Menorrhagia is still relevant and will be used for discussion below.

Causes of Menorrhagia – Secondary

The causes of secondary Menorrhagia are usually referred to a specialized clinic through a physical examination and a detailed history.

Cervical abnormalities indicate the presence of uterine lupus erythematosus (AUB / HMB-L);

This results in a list of factors that are organized similarly to dysmenorrhea: intracavitary, intramural, and extramural.

Despite their theoretical importance, most of the diseases that cause severe pain to the patient are found in utero. Studies show that approximately 60% of women who have heavy bleeding during menstruation have mastitis, 30% have endometrial polyps, and 20% have fibroids.

Hysteroscopy Study of Women with Heavy Menstrual Bleeding Adjusted by Measuring Blood Pressure In 1990, Fraser reported similar rates. Interstitial diseases associated with heavy menstrual bleeding can cause symptoms as a result of problems with the normal hemostatic control system.

The abnormal formation or function of the fallopian tubes occurs in endometrial polyps and endometrial cancer, the surface is unstable and weakens the ability to control blood flow. Cervical abnormalities should be suspected when an unusual and invasive procedure for severe menstrual bleeding appears to aggravate the problem.

Patients with these disabilities often have a history of failed pregnancies, obstetrics, gynecology, or surgery.

Mechanical disturbances with narrow pressure of the polyps or the development of leiomyotes can lead to blood clots. Wall-to-wall leukemia, or an enlargement of the arteries associated with its development, can contribute to severe menstrual bleeding.

Endometrial hyperplasia Strengthened endometrium Weak endometrial cell walls produce more arachidonic acid when combined with phospholipids. Cellular irritability caused by non-hormonal contraceptives or endometritis promotes the formation or release of cytokines and prostaglandins.

In each case, the risk of severe menstrual cramps is well understood, or may be a plausible hypothesis, even if they are not the underlying causes of the underlying disease.

Causes of Menorrhagia – Primary

Unlike primary dysmenorrhea, which is said to be the sole cause of nonspecific clinical manifestations, prostaglandin production must be considered in the absence of a number of underlying (non-clear clinical) causes at primary menopause.

For example, a large amount of menstrual bleeding may be the result of AUB / HMB-C or an aerobic antibody (AUB / HMB-I), there are no outward signs, but if these symptoms are rare, they are historically related or related. looking for Recommendations.

Severe menstrual flow can be the result of physical changes not seen on physical examination, although it can be argued that ultrasound can be recorded in many cases. Older patients should always be considered, even in the absence of cervical cancer (AUB / HMB-M), which is a risk factor for hospital-acquired bleeding.

Considering the availability and simplicity of both endometrial histological specimens and ultrasound images, many would argue that these procedures should be classified as primary and secondary anemia. We will follow that meeting for this discussion.

Although menorrhagia can be caused by a systemic or musculoskeletal disorder, no pathology is found in about 50% of cases, and most women with meningitis have a normal ovulation cycle. Thromboxane A2 (TXA2) and prostaglandin E2 (PGE2) are known to cause severe menstrual bleeding in these women.

Studies show that women with menorrhagia have elevated levels of prostaglandins (PGE2, PGF2α, and PGI2) and PGE2 and PGF2α. Although the role of leukocytes in menopause has been studied, no link has been found between the endometrium or myometrium and menstrual bleeding.

For most patients, the abundant production of TXA2 and PGF2 is due to the presence of the arachidonic acid substrate used in cyclosporine, lipoxygenase, and epoxygenases.. Any process, including secretory changes related to the normal ovarian cycle, results in a fertile endometrium, giving the placenta a large volume.

What is the Causes of Menorrhagia

Risk factor’s

Critical risk factors in the literature include aging, premenopausal leiojomas, and endometrial polyps.

Since bleeding is a very common symptom for these types of diseases, it should be noted that calling them risk factors has little clinical significance. Body mass index, body mass index, physical activity, level of education, and risk factors for smoking have not been established, although weight is associated with longer cycles.

In some studies, up to 20% of women with menstrual bleeding experience inherited bleeding. Compared with women without such discomfort, the incidence of anemia, severe menopause, and sexual dysfunction doubled, and this should be considered with the patient.

Women with heavy menstrual bleeding have been reported to have elevated levels of cytokinesis (COX-1, COX-2) and endometrial stimulation with prostaglandins. Although none of them are accurate, this observation indicates a tendency to heavy menstrual bleeding.


  • Historical classification of the causes of severe menstrual bleeding similar to menstrual bleeding: primary and secondary.
  • Abnormal menstrual bleeding The PALM-COEIN classification is helpful for most types of abnormal bleeding, but it is not very helpful in describing the causes of heavy, pulse menstrual bleeding.
  • Unlike primary dysmenorrhea, additional hospital and cervical cavity evaluations should be performed before the cause of severe menstrual bleeding is not immediately clinical.
  • The only risk factors for heavy menstrual flow are related to secondary vascular disorders.
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