Summary
Definition
History and exam
Other diagnostic factors
- use of medications
- menstrual irregularity
- anaemia
- premenstrual molimina
- hirsutism, acne, acanthosis nigricans
- existing medical illness
Risk factors
- women at the extremes of reproductive age (just after puberty and before menopause)
- polycystic ovary syndrome
- endocrine disorders
- other anovulatory disorders
- obesity
Diagnostic investigations
Investigations to consider
- coagulation profile
- serum TSH level
- ultrasound scan
- hysteroscopy
- endometrial biopsy
Treatment algorithm
Contributors
Authors
Professor of Obstetrics and Gynaecology
Centre for Women's and Newborn Health
Institute of Metabolism and Systems Research
University of Birmingham
Birmingham Women’s and Children’s Hospital
Birmingham
UK
Disclosures
JG is an advisory member for Femcare Nikomed UK for the Filshie clip. He has received an HTA grant for the ECLIPSE trial; a randomised controlled trial comparing the Mirena coil with oral medical treatments for heavy menstrual bleeding. He has received travel costs for training workshops for Dilapan-S osmotic dilators for abortion and the induction of labour (Medicem).
Senior Clinical Fellow
Department of Reproductive Medicine
St. Mary’s Hospital
Manchester
UK
Disclosures
AS declares that she has no competing interests.
Clinical Research Fellow
MRC Centre for Reproductive Health
The Queen's Medical Research Institute
University of Edinburgh
Scotland
UK
Disclosures
RC is supported as a Clinical Research Fellow by Bayer AG; RC declares that he has no other competing interests.
Professor Gupta, Dr Sood, and Dr Chodankar would like to gratefully acknowledge Dr Mohamed Mitwally and Dr Intisar Elnahhas, the previous contributors to this topic. MM owns a patent on the use of aromatase inhibitors for endometrial thinning before hysteroscopic surgery. The patent is licensed to Meditrina Company. IE declares that she has no competing interests.
Peer reviewers
Associate Professor
Department of Family and Community Medicine
Southern Illinois University School of Medicine
Springfield
IL
Disclosures
JA is an author of a reference cited in this topic.
Associate Professor (CHS)
Department of Family Medicine
University of Wisconsin
WI
Disclosures
SS declares that she has no competing interests.
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