It can occur due to any of several causes, including hormonal imbalance, endometriosis, uterine fibroids, usage of progestin-only contraception, or cancer. Not least, it can be caused by deficiencies of several clotting factors. It can lead to anemia in long-standing cases.
The initial workup includes exclusion of pregnancy and cancer, by performing a pregnancy test, a pelvic exam and a gynecologic ultrasound. Further workup depends on outcomes of the preceding tests and may include hydrosonography, hysteroscopy, endometrial biopsy, and magnetic resonance imaging.
Treatment depends on the cause. In cases where malignancy is ruled out, hormone supplementation or the therapeutic use of hormonal contraception is usually recommended to induce bleeding on a regular schedule. Selective progesterone receptor modulators (SPRMs) are sometimes used to stop uterine bleeding.
It occurs in up to 24% of women ages 40-55 years.
- Bouchard, Philippe (December 2011). "Current and future medical treatments for menometrorrhagia during the premenopause". Gynecological Endocrinology. 27 (Supplement 1): 1120–1125. doi:10.3109/09513590.2012.638754. ISSN 0951-3590. PMID 22182055.
- Donnez, J. (2011). "Menometrorrhagia during the premenopause: An overview". Gynecological Endocrinology. 27: 1114–1119. doi:10.3109/09513590.2012.637341. PMID 22182054.