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Heavy menstrual bleeding or menorrhagia
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Excessive
menstrual bleeding is a common gynaecological problem,
comprising 12% of all gynaecology referrals and is the commonest
symptom present during the reproductive life of women. Normal
menstruation occurs every 21 to 35 days, lasts 7 or less,
and results in 25 ml to 69 ml blood loss per cycle. Some
women have heavy periods almost every cycle. |
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Menorrhagia is the medical term
for excessive blood loss as heavy menses lasting more than
7 days; an objective definition is menstrual blood loss
of more than 80 mL per menstruation [1].
Objective assessment of menstrual blood loss, using the
alkaline haematin technique, has been shown to be very accurate
and reproducible, but it is not in routine clinical use.
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It is difficult to quantify menstrual blood loss objectively
because it involves techniques that are specialized, time-consuming
and require collection of sanitary material by women. As
a result, assessment of menorrhagia in clinical practice
is usually subjective and often relies on the description
provided by the patient. This method is unfortunately inaccurate
and there is lack of correlation between a patient's impression
and the objective assessment of actual volume of blood loss.
In an attempt to address this problem, a pictorial blood
loss assessment chart (PBAC) was developed (Figure1)
[2].
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This used a simple scoring system, taking into account
the number of sanitary items used and the degree of soiling.
Menorrhagia is a frequent problem that afflicts women
from menarche to menopause as well as in the postmenopausal
period. It has an enormous impact on women's lives and
may affect 25-30% of women at some point during their
child-bearing years.
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