{"id":126,"date":"2017-03-23T18:37:58","date_gmt":"2017-03-23T18:37:58","guid":{"rendered":"http:\/\/papergp.com\/index.php\/womens-health\/menorrhagia\/"},"modified":"2023-01-24T11:25:26","modified_gmt":"2023-01-24T11:25:26","slug":"menorrhagia","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/womens-health\/menorrhagia\/","title":{"rendered":"Menorrhagia"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Differential diagnosis<\/h4>\n<ul>\n<li>Endometrial Ca &#8211; IMB, PCB, weight loss<\/li>\n<li>Ovarian Ca &#8211; weight loss, bowel habit changes, abdominal distension, early satiety, pelvic pain<\/li>\n<li>Infection &#8211; fever, PV discharge, change in partner<\/li>\n<li>Fibroids &#8211; bloating, pressure symptoms (bladder, bowel)<\/li>\n<li>Others &#8211; thyroid disease, coagulation disease, liver disease<\/li>\n<li>Dysfunctional uterine bleeding &#8211; if above ruled out<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags &#8211; sudden onset, IMB, PCB, last smear<\/li>\n<li>Others &#8211; pads, clots, flooding, abdo pain, SOB\/palpitations\/lethargy, PV discharge, contraception, pregnancies<\/li>\n<li>Examine &#8211; abdomen, pelvis, speculum<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bloods &#8211; FBC, TFTs<\/li>\n<li>Swabs &#8211; vaginal, endocervical<\/li>\n<li>Cervical smear (if due)<\/li>\n<li>USS Pelvis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Explanation\n<ul>\n<li>many causes, changes in hormones, fibroids (benign growths), endometriosis (womb lining grows outside of the womb)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Menstrual diary<\/li>\n<li>Medications\n<ul>\n<li>Tranexamic acid 1g TDS from day 1 of cycle for four days<\/li>\n<li>Mefenamic acid 500mg TDS (if associated dysmenorrhoea)<\/li>\n<li>Mirena coil<\/li>\n<li>COCP \/ depot injection<\/li>\n<li>Norethisterone 5mg TDS day 5 &#8211; 26<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety net\n<ul>\n<li>Consider referral if failed treatment or secondary anaemia.<\/li>\n<li>Gynae can offer\u00a0endometrial ablation, hysterectomy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Endometrial Ca &#8211; IMB, PCB, weight loss Ovarian Ca &#8211; weight loss, bowel habit changes, abdominal distension, early satiety, pelvic pain Infection &#8211; fever, PV discharge, change in partner Fibroids &#8211; bloating, pressure symptoms (bladder, bowel) Others &#8211; thyroid disease, coagulation disease, liver disease Dysfunctional uterine bleeding &#8211; if above ruled out &nbsp; &hellip; <a href=\"https:\/\/papergp.com\/index.php\/womens-health\/menorrhagia\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Menorrhagia<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":122,"menu_order":107,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-126","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/126","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=126"}],"version-history":[{"count":8,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/126\/revisions"}],"predecessor-version":[{"id":1963,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/126\/revisions\/1963"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/122"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=126"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}