Intermenstrual Bleeding

Chapter 115 Intermenstrual Bleeding



INTRODUCTION



Description: Bleeding between otherwise normal menstrual cycles is called intermenstrual bleeding.

Prevalence: Ten percent to 15% of all gynecologic visits involve menstrual disturbances.

Predominant Age: Reproductive, greatest in adolescents and patients who are climacteric.

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Uterine (pregnancy, endometrial polyps, endometrial hyperplasia, endometrial carcinoma, leiomyomata), cervical (polyps, cervicitis, cervical erosion, cervical dysplasia/neoplasia), vaginal (trauma, infection, atrophy), perineal (vulvar lesions, hemorrhoids).

Risk Factors: None known. (The purported relationship to surgical sterilization has been disproved.)


CLINICAL CHARACTERISTICS



Signs and Symptoms



• Intermenstrual bleeding (painless)

• Bleeding after intercourse (common)


DIAGNOSTIC APPROACH



Differential Diagnosis



• Pregnancy

• Climacteric changes

• Anovulation

• Endometrial polyps

• Uterine leiomyomata

• Cervical polyps, lesions, or cervicitis

• Endometrial cancer

• Endometriosis

• Nonuterine sources of bleeding (e.g., vaginal, vulvar, or perineal)

• Coagulopathy (congenital or acquired)

• Iatrogenic (intrauterine device use, medications)

Related posts:

  1. Anemia
  2. Toxic Shock Syndrome
  3. Uterine Anomalies: Bicornuate, Septate, and Unicornuate Uterus
  4. Cervical Cancer

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Intermenstrual Bleeding

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