Menorrhagia Follow-up

  • Author: Julia A Shaw, MD, MBA, FACOG; Chief Editor: Michel E Rivlin, MD   more...
 
Updated: Mar 15, 2012
 

Complications

  • Treatment of menorrhagia must be individualized to treat each patient's specific symptoms. Cost, dosing, and patient compliance can play major roles.
  • If bleeding does not subside within the expected time frame, have the patient keep a menstrual calendar to better assess the resulting bleeding pattern.
  • If a specific treatment fails, investigate all possibilities, including noncompliance, medication dosing, diagnosis, patient age, and comorbid conditions.
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Prognosis

With proper workup, diagnosis, treatment, and follow-up care, prognosis is excellent.

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Patient Education

  • Reassure patients that most bleeding stops, but not immediately. Provide literature on the treatment of choice, including expectations and adverse effects.
  • Many patients appreciate reassurance that they do not have cancer and are not alone in their plight.
  • Reassure patients who experience a treatment failure that other options are available.
  • For excellent patient education resources, visit eMedicine's Women's Health Center. Also, see eMedicine's patient education articles Vaginal Bleeding, Amenorrhea, Fibroids, and Female Sexual Problems.
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Contributor Information and Disclosures
Author

Julia A Shaw, MD, MBA, FACOG  Assistant Clinical Professor and Associate Program Director, Department of Obstetrics and Gynecology, Yale School of Medicine; Medical Director, Yale-New Haven Hospital Women's Center

Julia A Shaw, MD, MBA, FACOG is a member of the following medical societies: American Association of Gynecologic Laparoscopists, American College of Obstetricians and Gynecologists, American College of Physician Executives, Connecticut State Medical Society, and North American Menopause Society

Disclosure: Nothing to disclose.

Coauthor(s)

Howard A Shaw, MD, MBA  Associate Clinical Professor of Obstetrics and Gynecology, Yale University School of Medicine; Chairman, Department of Women's and Children's Services, Hospital of Saint Raphael

Howard A Shaw, MD, MBA is a member of the following medical societies: American College of Forensic Examiners, American College of Healthcare Executives, American College of Obstetricians and Gynecologists, American College of Physician Executives, American Medical Association, American Society for Colposcopy and Cervical Pathology, American Urogynecologic Society, Association of Professors of Gynecology and Obstetrics, Central Association of Obstetricians and Gynecologists, Connecticut State Medical Society, International Urogynaecology Association, and Southern Medical Association

Disclosure: Athena Feminine Technologies Ownership interest Consulting

Specialty Editor Board

Thomas Michael Price, MD  Associate Professor, Division of Reproductive Endocrinology, Director of Reproductive Fellowship Training Program, Duke University Medical Center

Thomas Michael Price, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Obstetricians and Gynecologists, American Medical Association, American Society for Reproductive Medicine, Association of Professors of Gynecology and Obstetrics, Endocrine Society, Phi Beta Kappa, Society for Gynecologic Investigation, Society for Reproductive Endocrinology and Infertility, and South Carolina Medical Association

Disclosure: Clinical Advisors Group Consulting fee Consulting; MEDA Corp Consulting Consulting fee Consulting; Gerson Lehrman Group Advisor Consulting fee Consulting; Adiana Grant/research funds PI

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

A David Barnes, MD, PhD, MPH, FACOG  Consulting Staff, Department of Obstetrics and Gynecology, Mammoth Hospital (Mammoth Lakes, California), Pioneer Valley Hospital (Salt Lake City, Utah), Warren General Hospital (Warren, Pennsylvania), and Mountain West Hospital (Tooele, Utah)

A David Barnes, MD, PhD, MPH, FACOG is a member of the following medical societies: American College of Forensic Examiners, American College of Obstetricians and Gynecologists, American Medical Association, Association of Military Surgeons of the US, and Utah Medical Association

Disclosure: Nothing to disclose.

Frederick B Gaupp, MD  Consulting Staff, Department of Family Practice, Hancock Medical Center

Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.

Chief Editor

Michel E Rivlin, MD  Professor, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine

Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, and Royal College of Surgeons of Edinburgh

Disclosure: Nothing to disclose.

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Acute menorrhagia requires prompt medical intervention. This is bleeding that will compromise an untreated patient.
Successful treatment of chronic menorrhagia is highly dependent on a thorough understanding of the exact etiology. For instance, acute bleeding postpartum does not respond to progesterone therapy, while anovulatory bleeding worsens with high-dose estrogen.
Flow chart continued from Media file 2.
Flow chart continued from Media files 2 and 3.
 
 
 
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