Hysteroscopy and laparoscopy in women with menorrhagia

Article Abstract:

Menorrhagia is a disorder of menstruation marked by an increased blood loss. Diagnosis is difficult since the characteristics of a menstrual period may vary from cycle to cycle. The upper limit of normal blood loss is between 60 and 80 milliliters per cycle. In some cases, menorrhagia is clearly caused by tumors or endometriosis. In other cases, in-depth laboratory investigation may reveal a disorder of coagulation, lupus erythematosus or hypothyroidism. However, most cases of vaginal bleeding have unknown causes. The relative usefulness of visualizing the uterus with a hysteroscope, a device affixed with a magnifying lens inserted into the uterus through the vagina, or a laparoscope, a device inserted into the abdomen, for diagnosing menorrhagia, was studied. Menstrual blood loss was measured in 139 out of 182 women diagnosed with dysfunctional uterine bleeding. Of the 117 women having laparoscopy, half had no evidence of organic pelvic disease. In the women with a blood loss of less than 60 milliliters, 75 percent had a detectable abnormality. In the group of women with a moderate blood loss of 60 to 120 milliliters, 44 percent had no detectable abnormality. In the women with a blood loss of greater than 120 milliliters, 36 percent had no detectable abnormality. Patients with myomas, benign tumors of the uterine wall, were generally moderate to heavy bleeders. Of the women with endometriosis, a complication whereby cells that normally line the uterus dislodge, grow and function elsewhere in the body, 54 percent had heavy to moderate blood loss, 29 percent had excessive and 23 percent had normal blood loss. The high rate of pathological pelvic conditions found in women with menorrhagia supports the use of hysteroscopy and laparoscopy instead of the less diagnostically useful and less reliable blind curettage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hysteroscopy, Laparoscopy

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Case presentation: A patient with von Willebrand disease with menorrhagia

Article Abstract:

Some women with heavy menstrual bleeding may have a mild form of von Willebrand disease. This determination can be important in planning future simple surgical procedures. Blood tests on a 42-year-old woman who reported heavy menstrual bleeding revealed clotting abnormalities, long bleeding times and moderately low levels of a clotting factor called von Willebrand factor. Von Willebrand patterns, ultrasound and hormone tests were normal. Treatment with a nasal spray was effective in treating this patient.

Health aspects, Von Willebrand's disease

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Estradiol-delivering vaginal rings for hormone replacement therapy

Article Abstract:

A ring containing estradiol that can be placed inside the vagina appears to be an effective delivery device for hormone replacement therapy, according to a study of 35 women. The ring can be left in place for long periods of time, unlike a patch or a pill that must be taken every day.

Evaluation, Hormone therapy, Dosage and administration, Vagina, Medication by, Vaginal medication, Drug delivery devices

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