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2 results

  • Case 45 - A 55-Year-Old G1P1 Woman with New-Onset Vaginal Bleeding after Prior Endometrial Ablation

  • Edited by Todd R. Jenkins, University of Alabama, Birmingham, Lisa Keder, Abimola Famuyide, Kimberly S. Gecsi, David Chelmow
  • Book:
    Surgical Gynecology
    Published online:
    19 November 2021
    Print publication:
    02 December 2021, pp 137-139

  • Summary

    A 55-year-old gravida 1, para 1001 presents to the office with complaints of new-onset vaginal bleeding. She has not had a menstrual period since undergoing an endometrial ablation (EA) seven years ago. The vaginal bleeding started five days ago and is intermittent. She has been bleeding through three to four regular maxi-pads per day. Review of systems is negative for dizziness, fatigue, shortness of breath, and pelvic pain. She is currently sexually active with her husband, who underwent a vasectomy after the birth of their child. Her past medical history is significant for regular, heavy menstrual cycles. She denies a history of bleeding disorders, diabetes, or hypertension. She has no other pertinent surgical history. She has no family history of endometrial cancer. She is not taking any medications and has no drug allergies.

  • Chapter 17 - Ovarian cancer and masses

  • from Section 3 - Genitourinary concerns
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University School of Medicine
  • Book:
    Handbook of Women's Health
    Published online:
    26 December 2009
    Print publication:
    22 October 2009, pp 187-192

  • Summary

    Normal menstruation is the end product of a complex interplay of health and hormones. This chapter discusses the etiology, treatment and evaluation of amenorrhea, polycystic ovary disease and abnormal menstrual bleeding. Many of the causes of amenorrhea can also cause oligomenorrhea, metrorrhagia, menorrhagia, and other irregularities of menstruation. Primary amenorrhea occurs in adolescents who have never had a menstrual period. Women with amenorrhea can be placed on ovulation inducing drugs. An ovulation inducing agent, such as clomiphene is needed. Metformin may be used in those women with polycystic ovarian syndrome (PCOS). Metformin improves the endocrine symptoms of PCOS, even in women who are not diabetic. It treats insulin sensitivity, induces normal ovulatory cycles, and causes weight loss, although this is an off-label use. Heavy menstrual bleeding (HMB) is an important cause of ill health in women.