Menometrorrhagia, also known as heavy irregular menstrual bleeding, is a condition in which prolonged or excessive uterine bleeding occurs irregularly and more frequently than normal. It is thus a combination of metrorrhagia (intermenstrual bleeding) and menorrhagia (heavy/prolonged menstrual bleeding).

Causes

It can occur due to any of several causes, including hormonal imbalance, endometriosis, uterine fibroids, usage of progestin-only contraception, or cancer.^[1] Not least, it can be caused by deficiencies of several clotting factors. It can lead to anemia in long-standing cases.^{[citation needed]}

Diagnosis

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.^[2]

Treatment

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.^[1]

Epidemiology

It occurs in up to 24% of women ages 40-55 years.^[2]