How to Treat Abnormal Uterine Bleeding (SUA)

Many people confuse menorrhagia and hypermenorrhea, so let us first go to the definitions. Menorrhagia is bleeding out of the menstrual period. Hypermenorrhea is the prolonged bleeding in menstruation. Therefore, there are two symptoms that can mean different diagnoses.

We now prefer the term Abnormal Uterine Bleeding or SUA, which may be correlated with the menstrual cycle or not. In order to identify this type of bleeding, we must first exclude any possibility of pregnancy that may confuse the diagnosis, such as: abortion, ectopic pregnancy and other bleeding from the beginning of pregnancy or postpartum.

There are numerous causes of SUA and we need, with clinical, imaging, and laboratory examination, determine each case.

Subacute and acute bleeding problems should be evaluated for the need for some intervention to cease blood loss. Chronic cases, after clinical evaluation, usually do not require immediate intervention and are treated as outpatients.

Causes

• Polyps: pellets that resemble cysts and may form on the walls of the uterus
• Fibroids: tumors not cancerous of the uterus, which often appear during the fertile age
• Malignant diseases of the uterus, cervix and endometrium
• Adenomyosis: is the growth of the endometrium through the fibers of the myometrium
• Alterations of the endometrium, inflammation
• Coagulopathies Difficulty of blood clotting
• Ovarian dysfunction with changes in ovulation in adolescent, premenopausal, stress, polycystic ovary, etc.
• Latrogenic: the most common cases are inadequate use of pills, hormones, IUDs, anticoagulants , etc.

It is not uncommon to find the existence of one or more causes of SUA. In order to properly diagnose and evaluate the patient, we must have clinical and laboratory examination. It is also interesting the hormonal evaluation of ovulation and its phases to exclude some coagulopathy, to investigate the structure of the uterine cavity and the endometrium, releasing, if necessary, imaging such as Pelvic and Transvaginal Ultrasonography and Magnetic Resonance. , of the Hysteroscopy, which evaluates the inner part of the uterus with a camera.

SUA, therefore, comprises numerous pathologies, which must first be diagnosed in order to achieve an objective and correct treatment. The increased intensity of the menstrual flow compromises the patient's quality of life both by the bleeding itself and by its greater effect, the anemia.

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