Metrorrhagia

Metrorrhagia
Classification and external resources
Specialty
ICD-10	N92.1, N92.4
ICD-9-CM	626.6
DiseasesDB	6847
Patient UK	Metrorrhagia
MeSH	D008796

Metrorrhagia (metro = womb, -rrhagia = excessive flow) is uterine bleeding at irregular intervals, particularly between the expected menstrual periods.

In some women, menstrual spotting between periods occurs as a normal and harmless part of ovulation. Some women experience acute mid-cycle abdominal pain around the time of ovulation (sometimes referred to by the German term for this phenomenon, mittelschmerz). This may also occur at the same time as menstrual spotting. The term breakthrough bleeding or breakthrough spotting is usually used for women using hormonal contraceptives, such as IUDs or oral contraceptives, in which it refers to bleeding or spotting between any expected withdrawal bleedings, or bleeding or spotting at any time if none is expected. If spotting continues beyond the first three cycles of oral contraceptive use, a woman should have her prescription changed to a pill containing either more estrogen or more progesterone.

Metrorrhagia may also be a sign of an underlying disorder, such as hormone imbalance, endometriosis, uterine fibroids, or cancer of the reproductive organs.

Due to repeated and heavy bleeding, it can cause significant iron deficiency anemia.

Cause

Intermittent spotting between periods can result from any of numerous reproductive system disorders.

Neoplasia:

• Cervical cancer
• Uterine cancer
• Vaginal cancer
• Endometrial cancer
• Primary fallopian tube cancer
• Ovarian cancer

Inflammation:

• Cervicitis
• Endometritis
• Vaginitis
• Sexually Transmitted Infections
• Pelvic inflammatory disease

Endometrial abnormalities:

• Endometriosis
• Adenomyosis
• Uterine leiomyomas
• Endometrial hyperplasia
• Polyps

Endocrinological causes:

• Hormone imbalance
• Dysfunctional uterine bleeding
• Diets which induce ketosis, such as the Atkins diet
• polycystic ovarian syndrome

Bleeding disorders:

• Von Willebrand Disease
• Pancytopenia due to leukemia

Drug induced:

• Use of progestin-only contraceptives, such as Depo Provera
• Change in oral contraception
• Overdose of anticoagulant medication or Aspirine abuse

Traumatic causes:

• Trauma
• Automutilation
• Sexual abuse or rape

Related to pregnancy:

• Implantation bleeding
• Ectopic pregnancy
• (Incomplete) miscarriage

Other causes:

• Enlarged uterus with menorrhea

See also

• Menometrorrhagia
• Menstruation