Changes to menstrual frequency, regularity, duration, and volume of flow outside of pregnancy.

normal:

• frequency 24-38 days
• lasts 2-7 days
• 5-80mls of blood loss.

<aside> 💡 Older terms such as oligomenorrhea, menorrhagia, and dysfunctional uterine bleeding should be discarded in favour of using simple terms to describe the nature of abnormal uterine bleeding.

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In subpopulations:

• Reproductive age: pregnancy until proven otherwise
• Post-menopausal: malignancy until proven otherwise
• Adolescents: consider undiagnosed coagulation disorder
• Pre-menarche: always consider trauma or sexual abuse

Epidemiology:

up to 1/3 women at some stage in their lifetime

Terms

• Amenorrhea
• Oligomenorrhea: fewer than 6-8 periods/year
• Dysmenorrhea: painful periods
• Menorrhagia: abnormally heavy or prolonged periods
  • Coagulopathy (inherited, medication)Fibroids/leiomyoma
• Post-coital: Bleeding or spotting post-intercourse that is unrelated to menstruation
  • Polyps
  • Infection
  • Irritation
  • Cervical ectropion
  • Pregnancy (+miscarriage)
• Intermenstrual bleeding: Bleeding or spotting in-between menstrual period
  • Fibroids, PID, endometrial cancer