Feminine hygiene: When the rules go awry!

Many women are concerned about approaching the date of their rules, because they know they will lose torrents of blood for eight or ten days. Others are embarrassed by bleeding outside the rules. One in five women between 35 and 50 years would be concerned. How to treat these disorders?

In some women, the period lasts seven days or more are very abundant, it is called menorrhagia. For others, bleeding occurs during the cycle, with no rules (bleeding), but sometimes the two disorders are associated (menometrorrhagia). “We can say that it’s a real public health problem” says Prof. Herve Fernandez Beclere hospital in Clamart. To address these problems, several options are available.

Six or seven days protections

The rules are found to be abnormally abundant when they impose to use at least six or seven guards per day. But in extreme cases, this may be true “flooding” menstrual, forcing them to use dozens of daily coverage. In these cases anemia develops rapidly. These menorrhagia must be differentiated from simple heavy periods (hypermenorrhea).

The average volume of menstrual flow is 35 ml, with significant variations according to women. We talk about menorrhagia from 80 ml.
Similarly, the bleeding must be distinguished from simple spotting, spotting generally anarchic related to the pill.

Search injury

Bleeding is most often related to injury “organic” in the uterus fibroma, myoma, polyp or cancer, whose treatment is essentially surgical. However, in 80% of cases, menorrhagia due to hormonal imbalance and described as “functional.” This diagnosis may not be retained after a careful review, to search for a uterine lesion. This evaluation should include at least one gynecological examination with ultrasound, preferably with a vaginal probe ( ultrasound transvaginal), possibly supplemented by other tests, such as hysteroscopy (endoscopic examination of the uterus).

The meno-metrorrhagia functional is not a serious disease but can cause severe discomfort in daily life. At the request of the company Gynecare, the Ipsos institute conducted a survey of 150 women with very heavy or anarchy rules and 101 medical gynecologists and obstetricians. The results show significant impairment of quality of life:

• 31% of these women do not dare go swimming;
• 28% never wear light-colored clothing;
• 24% seem to be less desirable;
• 11% are hampered in their work.

Curiously, despite the inconvenience, 42% of women had not discussed their problems with their gynecologist and 66% reported not follow any treatment.

First, drug treatment

The management of meno-metrorrhagia functional is initially medical. In young women, it is based on the combined or progestogen-only pill, respecting the usual cons-indications. With the approach of menopause, preference is given to a progestogen-only pill normodosée, the 8 th to 26 th day of the cycle. However, this treatment often causes spotting (micro-bleeding). The success rate does not exceed 50%.

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