Metrorrhagia: when to worry?

What is metrorrhagia?

These are more or less abundant losses of red or blackish blood outside of menstruation. They can be associated with abdominal and pelvic pain. The reasons for bleeding vary depending on the age of the patient. A gynecological examination will be necessary to be able to make an accurate diagnosis.

What are the possible causes of bleeding?

Before puberty, this unexpected bleeding can be linked to the presence of a foreign body in the vagina, vulvar or vaginal lesions, or even precocious puberty. They require a quick consultation with the doctor to perform a pelvic examination.

While irregular periods are a classic phenomenon inadolescence, in women, unexpected bleeding outside of menstruation may indicate the presence of uterine pathology which requires prompt consultation with a healthcare professional.

In adult women, they can be the symptoms:

  • hemorrhagic pathology;
  • hormonal imbalance;
  • unbalanced hormonal treatment, or forgetting to take birth control pills;
  • insertion of an IUD;
  • endometriosis; 
  • a blow received in the genital area;
  • the presence of uterine polyps or fibroids;
  • cancer of the cervix, endometrium or in rare cases of the ovaries.

Metrorrhagia in pregnant women

If bleeding is noticed during pregnancy, contact your doctor immediately for further examinations. Most often harmless during first trimester due to the fragility of the cervix, metrorrhagia can nevertheless be a symptom of a miscarriage or an ectopic pregnancy, especially if they are accompanied by severe abdominal pain. Quick support is then necessary.

From the second trimester of pregnancy, metrorrhagia may be the cause of abnormally low insertion of the placenta in the uterus, or a retro-placental hematoma – located at the back of the placenta – which requires urgent medical consultation.

Bleeding after menopause

Menopause is a natural physiological process that marks the final end of fertility of a woman. Bleeding in postmenopausal women – called postmenopausal bleeding – are therefore considered all the more abnormal.

Different causes can explain this blood loss after menopause:

  • the presence of a uterine polyp or fibroid;
  • an ovarian cyst (most often accompanied by pelvic pain);
  • poorly dosed or unsuitable hormonal treatment; 
  • vaginal infection; 
  • inflammation of the cervix; 
  • sexual intercourse associated with thinning and / or drying of the vaginal mucosa; 
  • cancer of the cervix or endometrium.

How to treat metrorrhagia?

Most often, a pelvic examination will be prescribed in addition to blood tests, uterine ultrasound and a smear. They will allow a diagnosis to be made quickly. 

The treatments considered obviously depend on the cause of the bleeding. In the event of hormonal dysfunction, drug treatment may be prescribed to regulate the menstrual cycle. If the blood loss is related to an infection, antibiotics may be given. Finally, surgical treatment will be considered in more serious cases. 

In all cases, only your doctor is authorized to make a diagnosis on bleeding.

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