Materiały źródłowe

• #1 Menorrhagia (Heavy Menstrual Bleeding): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding

  Menorrhagia or heavy menstrual bleeding is a common disorder among people who menstruate. It refers to bleeding lasting longer than seven days and involves bleeding more than is typical during menstruation. […] Contact a healthcare provider if any of these scenarios apply to you. They can evaluate your symptoms and figure out what’s causing you to have heavy periods. Then, they can recommend treatment options to manage heavy blood flow during your period. […] Heavy menstrual bleeding is common, affecting anywhere from 27% to 54% of people who menstruate. […] Heavy menstrual bleeding interferes with your quality of life. Many people with heavy periods assume that periods are supposed to be inconvenient and uncomfortable. […] If your periods are disrupting your life, it’s time to see your provider.

• #2 Managing Heavy Menstrual Bleeding | Ausmed

  https://www.ausmed.com/learn/articles/heavy-menstrual-bleeding

  Heavy menstrual bleeding is the most common type of abnormal uterine bleeding, affecting 25% of women at reproductive age (ACSQHC 2017). […] Heavy menstrual bleeding is defined by the Australian Commission on Safety and Quality in Health Care as: Excessive menstrual blood loss which interferes with the woman’s physical, emotional, social and material quality of life, and which can occur alone or in combination with other symptoms (2017). […] Symptoms that may indicate heavy menstrual bleeding include: Bleeding through clothing, Being unable to leave the house due to bleeding, Changing pads and tampons often (including during the night), Passing large clots (bigger than a 50c coin), Having to use towels or large maternity pads while sleeping, Prolonged bleeding that lasts for over eight days, Anaemia-related symptoms caused by a drop in iron and red blood cells (fatigue, weakness, dizziness, shortness of breath, chest pains).

• #3 Heavy menstrual bleeding – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829

  Some women have menstrual bleeding that is heavy or lasts for more than a few days. This condition used to be called menorrhagia. Heavy menstrual bleeding is a common concern. But most women don’t have enough blood loss for it to be called heavy menstrual bleeding. […] With heavy menstrual bleeding, blood flow and cramping make it harder to do your usual activities. If you dread your period because you have heavy menstrual bleeding, talk with your doctor. There are many treatments that can help. […] Symptoms of heavy menstrual bleeding may include: Soaking through one or more sanitary pads or tampons every hour for several hours in a row. Needing double sanitary protection to control your menstrual flow. Getting up at night to change sanitary pads or tampons. Bleeding for more than a week. Passing blood clots larger than a quarter. Limiting daily activities due to heavy menstrual flow. Feeling tired, fatigued or short of breath as the result of blood loss.

• #4 Heavy Menstrual Bleeding – Together by St. Jude™

  https://together.stjude.org/en-us/treatment-tests-procedures/symptoms-side-effects/heavy-menstrual-bleeding.html

  Heavy menstrual bleeding (also called menorrhagia) is when menstrual periods are unusually heavy or last more than 7 days. […] Heavy bleeding can interfere with daily life and emotional health. Loss of blood during heavy periods can also cause health problems such as iron-deficiency anemia. […] Heavy menstrual bleeding can be one of the first signs of a bleeding disorder. It is important to talk to your health care provider about your symptoms and treatment options. […] Signs and symptoms of heavy menstrual bleeding may include: Needing to change your pad or tampon every 2 hours or more often, Periods that last longer than 7 days, Passing blood clots larger than the size of a quarter (about 1 inch), Needing to change your pad or tampon during the night, Bleeding through your clothes or bedding, Needing to use double protection (a pad and a tampon), Feeling tired, weak, or short of breath.

• #5 Nursing Care Plan for Abnormal Uterine Bleed – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-abnormal-uterine-bleed/

  Abnormal uterine bleed (AUB) is a common gynecological condition characterized by irregular, excessive, or prolonged bleeding from the uterus. It can significantly impact a womans quality of life and requires comprehensive nursing care to address the physical, emotional, and educational needs of the patient. […] The nursing assessment for abnormal uterine bleed (AUB) is a crucial step in understanding the patients condition, identifying potential underlying causes, and developing an individualized care plan. […] Nursing diagnoses are critical in identifying and addressing the specific needs of patients experiencing abnormal uterine bleeding (AUB). By formulating accurate nursing diagnoses, nurses can develop targeted interventions and prioritize care to promote patient well-being. […] Planning effective nursing interventions is vital in addressing the needs of patients experiencing abnormal uterine bleeding (AUB). A comprehensive nursing care plan tailored to the individual patients needs promotes optimal outcomes and supports the womans overall well-being.

• #6 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] A member of your health care team will likely ask about your medical history and menstrual cycles. You may be asked to keep a diary to track days with and without bleeding. Record information such as how heavy your flow was and how many sanitary pads or tampons you needed to control it. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #7 Heavy menstrual bleeding: diagnosis and management options – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/heavy-menstrual-bleeding-diagnosis-and-management-options

  Heavy menstrual bleeding has a major impact on a woman’s quality of life. This article covers the most recent guidance and treatment options available. Heavy menstrual bleeding (HMB) is one of the most common gynaecological disorders affecting women of reproductive age. Menorrhagia, also known as heavy menstrual bleeding (HMB), is widely accepted as the loss of menstrual blood of ≥60–80ml per cycle, compared with 30–40ml for the average woman with ‘normal’ periods. Women with HMB may describe having to use both tampons and sanitary towels, having to frequently change sanitary towels, and/or the presence of large menstrual clots. These can negatively impact activities of daily living (e.g. avoiding playing sports or going out). The National Institute for Health and Care Excellence (NICE) defines HMB more holistically as “excessive blood loss that interferes with the woman’s physical, emotional, social and material quality of life.”

• #8 Heavy menstrual bleeding: assessment and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493300/

  Recognise that heavy menstrual bleeding (HMB) has a major impact on a womans quality of life, and ensure that any intervention aims to improve this rather than focusing on blood loss. […] Take a history from the woman that covers: the nature of the bleeding, related symptoms, such as persistent intermenstrual bleeding, pelvic pain and/or pressure symptoms, that might suggest uterine cavity abnormality, histological abnormality, adenomyosis or fibroids, impact on her quality of life, other factors that may affect treatment options (such as comorbidities or previous treatment for HMB). […] Take into account the range and natural variability in menstrual cycles and blood loss when diagnosing HMB, and discuss this variation with the woman. If the woman feels that she does not fall within the normal ranges, discuss care options.

• #9 Heavy menstrual bleeding: work-up and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6142441/

  Heavy menstrual bleeding (HMB), which is the preferred term for menorrhagia, affects 90% of women with an underlying bleeding disorder and 70% of women on anticoagulation. […] The goal of the work-up is to determine whether there is a uterine/endometrial cause, a disorder of ovulation, or a disorder of coagulation. […] HMB manifest by flooding and/or prolonged menses, or HMB accompanied by a personal or family history of bleeding is very suggestive of a bleeding disorder and should prompt a referral to a hematologist. […] The goal of treatment is to reduce HMB. Not only will the treatment strategy depend on whether there is ovulatory dysfunction, uterine pathology, or an abnormality of coagulation, the treatment strategy will also depend on the age of the patient and her desire for immediate or long-term fertility.

• #10 Heavy Menstrual Bleeding | ACOG

  https://www.acog.org/womens-health/faqs/heavy-menstrual-bleeding

  Heavy menstrual bleeding is very common. About one third of women seek treatment for it. Heavy menstrual bleeding is not normal. It can disrupt your life and may be a sign of a more serious health problem. If you are worried that your menstrual bleeding is too heavy, tell your obstetrician-gynecologist (ob-gyn). […] Heavy menstrual bleeding may be a sign of an underlying health problem that needs treatment. Blood loss from heavy periods also can lead to a condition called iron-deficiency anemia. Severe anemia can cause shortness of breath and increase the risk of heart problems. […] Medications often are tried first to treat heavy menstrual bleeding: Heavy bleeding caused by problems with ovulation, endometriosis, PCOS, and fibroids often can be managed with certain hormonal birth control methods. Depending on the type, these methods can lighten menstrual flow, help make periods more regular, or even stop bleeding completely.

• #11 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] A member of your health care team will likely ask about your medical history and menstrual cycles. You may be asked to keep a diary to track days with and without bleeding. Record information such as how heavy your flow was and how many sanitary pads or tampons you needed to control it. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #12 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] A member of your health care team will likely ask about your medical history and menstrual cycles. You may be asked to keep a diary to track days with and without bleeding. Record information such as how heavy your flow was and how many sanitary pads or tampons you needed to control it. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #13 Nursing Care Plan for Abnormal Uterine Bleed – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-abnormal-uterine-bleed/

  Abnormal uterine bleed (AUB) is a common gynecological condition characterized by irregular, excessive, or prolonged bleeding from the uterus. It can significantly impact a womans quality of life and requires comprehensive nursing care to address the physical, emotional, and educational needs of the patient. […] The nursing assessment for abnormal uterine bleed (AUB) is a crucial step in understanding the patients condition, identifying potential underlying causes, and developing an individualized care plan. […] Nursing diagnoses are critical in identifying and addressing the specific needs of patients experiencing abnormal uterine bleeding (AUB). By formulating accurate nursing diagnoses, nurses can develop targeted interventions and prioritize care to promote patient well-being. […] Planning effective nursing interventions is vital in addressing the needs of patients experiencing abnormal uterine bleeding (AUB). A comprehensive nursing care plan tailored to the individual patients needs promotes optimal outcomes and supports the womans overall well-being.

• #14 Heavy Menstrual Bleeding | ACOG

  https://www.acog.org/womens-health/faqs/heavy-menstrual-bleeding

  Heavy menstrual bleeding is very common. About one third of women seek treatment for it. Heavy menstrual bleeding is not normal. It can disrupt your life and may be a sign of a more serious health problem. If you are worried that your menstrual bleeding is too heavy, tell your obstetrician-gynecologist (ob-gyn). […] Heavy menstrual bleeding may be a sign of an underlying health problem that needs treatment. Blood loss from heavy periods also can lead to a condition called iron-deficiency anemia. Severe anemia can cause shortness of breath and increase the risk of heart problems. […] Medications often are tried first to treat heavy menstrual bleeding: Heavy bleeding caused by problems with ovulation, endometriosis, PCOS, and fibroids often can be managed with certain hormonal birth control methods. Depending on the type, these methods can lighten menstrual flow, help make periods more regular, or even stop bleeding completely.

• #15 Women’s experiences of heavy menstrual bleeding and medical treatment: a qualitative study in primary care | British Journal of General Practice

  https://bjgp.org/content/73/729/e294

  Heavy menstrual bleeding (HMB) is common and can affect womens lives. […] Women reported the wide-ranging and debilitating impact of HMB on their lives. […] They could then be frustrated by lack of a medical explanation for HMB. […] Experiences of medical treatments varied considerably but were strongly influenced by the perceived quality of healthcare interactions with clinicians. […] Clinicians should be aware of the considerable challenges faced by women with HMB; widely differing experiences of, and influences on, their treatment; and the value of patient-centred communication in this context. […] Heavy menstrual bleeding (HMB) has been reported by 27-36% of women in surveys and is a common reason for consultation in primary care. […] Women had concerns about volume of blood loss with their HMB and its implications, experiencing iron-deficiency anaemia and related hair loss.

• #16 Heavy menstrual bleeding: assessment and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493300/

  Consider starting pharmacological treatment for HMB without investigating the cause if the womans history and/or examination suggests a low risk of fibroids, uterine cavity abnormality, histological abnormality or adenomyosis. […] Offer outpatient hysteroscopy to women with HMB if their history suggests submucosal fibroids, polyps or endometrial pathology. […] Ensure that outpatient hysteroscopy services are organised and the procedure is performed according to best practice, including advising women to take oral analgesia before the procedure. […] Provide women with information about HMB and its management. […] Provide information about all possible treatment options for HMB and discuss these with the woman. […] Explain to women who are offered an LNG-IUS about anticipated changes in bleeding pattern, particularly in the first few cycles and maybe lasting longer than 6 months.

• #17

  https://www.nursingcenter.com/cearticle?an=01938899-202302280-00001&Journal_ID=5188715&Issue_ID=6567565

  Heavy menstrual bleeding (HMB) is a common problem in adolescents. Untreated HMB may result in deleterious medical, psychological, and social consequences. Patients often benefit from a multidisciplinary team, which can include an obstetrician/gynecologist, adolescent medicine specialist or pediatrician, hematologist, and mental health provider. […] The purpose of this article is to provide up-to-date guidance on evaluating, diagnosing, and managing HMB in adolescents. […] Medical complications of untreated HMB in adolescents include symptomatic iron deficiency with or without anemia, which may cause fatigue, weakness, and deficits in attention and concentration. […] Adolescents with HMB may present with severe iron-deficiency anemia, requiring blood transfusion, urgent care and emergency department visits, and hospitalization.

• #18 Heavy menstrual bleeding – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829

  Adenomyosis. In this condition, glands from the lining of the uterus grow into the wall of the uterus itself. This can cause heavy bleeding and painful periods. […] Heavy menstrual bleeding can cause anemia related to blood loss. Anemia is a condition in which the body lacks enough red blood cells to carry oxygen to tissues. The number of red blood cells is measured by hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen to tissues throughout the body. […] Along with heavy menstrual bleeding, you might have painful menstrual cramps. This also is known as dysmenorrhea. Talk to your doctor if your cramps make it hard to do your daily activities.

• #19

  https://www.nursingcenter.com/cearticle?an=01938899-202302280-00001&Journal_ID=5188715&Issue_ID=6567565

  HMB is acutely managed based on severity. For adolescents presenting with normal vital signs and a hemoglobin level higher than 8 g/dL, guidelines are outlined in the „Chronic Management” section next. […] Hormonal medication is typically used as a first-line treatment to stabilize the endometrium and stop or diminish active bleeding. […] Chronic management starts after outpatient evaluation of HMB in a stable patient, or after hormonal medication is tapered to once-daily dosing after an acute intervention. […] The FIGO definition of HMB includes the impact on social and emotional well-being; thus, psychosocial support is important. […] Quality-of-life surveys from adolescents with HMB show that school is the most affected domain, manifesting as missed school days, decreased concentration and increased fatigue in class, decreased participation in sports and physical activity, increased feelings of isolation from peers, and anxiety. […] HMB negatively affects self-esteem, school attendance, and participation in sports, and results in an increase in anemia, iron deficiency, depression, fatigue, and emergency department utilization.

• #20 Nursing Care Plan for Abnormal Uterine Bleed – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-abnormal-uterine-bleed/

  A nursing care plan for abnormal uterine bleeding involves a comprehensive and patient-centered approach that addresses the physical, emotional, and educational aspects of care. By providing appropriate interventions, emotional support, education, and collaboration with the healthcare team, nurses play a vital role in promoting the well-being and quality of life of women with abnormal uterine bleeding.

• #21 What will the ER do for heavy menstrual bleeding?

  https://www.medicalnewstoday.com/articles/what-will-er-do-for-heavy-menstrual-bleeding

  If a person is losing a lot of blood from a heavy period, and it is making them feel weak, dizzy, or sick, they should visit the emergency room (ER). Treatment may include medications to slow the bleeding, fluids, and, in some cases, blood transfusion. […] If the amount of bleeding is not a medical emergency but a person regularly experiences heavy periods, or menorrhagia, a doctor may refer someone to a gynecologist. […] A person should go to the ER if they have bleeding that soaks through one or more pads or tampons per hour over the course of several hours. […] When a person visits the ER due to heavy menstrual bleeding, the first priority is to make sure they are stable. […] Treatment for heavy bleeding first involves stabilizing the person and stopping the bleeding. […] If a person is unstable, a doctor will give IV fluids. They may also recommend a blood transfusion.

• #22 Heavy menstrual bleeding – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829

  Some women have menstrual bleeding that is heavy or lasts for more than a few days. This condition used to be called menorrhagia. Heavy menstrual bleeding is a common concern. But most women don’t have enough blood loss for it to be called heavy menstrual bleeding. […] With heavy menstrual bleeding, blood flow and cramping make it harder to do your usual activities. If you dread your period because you have heavy menstrual bleeding, talk with your doctor. There are many treatments that can help. […] Symptoms of heavy menstrual bleeding may include: Soaking through one or more sanitary pads or tampons every hour for several hours in a row. Needing double sanitary protection to control your menstrual flow. Getting up at night to change sanitary pads or tampons. Bleeding for more than a week. Passing blood clots larger than a quarter. Limiting daily activities due to heavy menstrual flow. Feeling tired, fatigued or short of breath as the result of blood loss.

• #23 Heavy periods (menorrhagia) | healthdirect

  https://www.healthdirect.gov.au/heavy-periods

  Heavy menstrual bleeding is excessive blood loss that interferes with your physical, social or emotional quality of life. Losing a lot of blood during your periods can be very distressing. […] Speak to your doctor if your periods are heavy or affecting your quality of life. […] Heavy periods can lead to low iron levels and anaemia. […] Your doctor will ask you about your symptoms and general health. They may also examine you and may arrange for tests such as blood tests and an ultrasound scan. […] Your doctor may refer you to a gynaecologist (specialist doctor who manages conditions that affect the female reproductive system) for tests and treatment. […] Speak with your doctor if you are worried about heavy periods or they’re affecting your everyday life. […] Heavy periods can generally be managed with medicines or surgery.

• #24 Nursing care plan for abnormal uterine bleeding

  https://nursipedia.com/nursing-care-plan-abnormal-uterine-bleeding/

  Abnormal Uterine Bleeding (AUB) is a medical condition perceived as the excessive or prolonged bleeding from the uterus. It presents in form of irregular menstruation, prolonged uterine bleeding that can result in iron deficiency anemia, and heavy menstrual flow. […] The expected outcomes of AUB nursing care plan implies stabilizing bleeding pattern in the patient with possible corrective measure to avoid further bleeding amid abnormal uterine bleeding. It also implies maintaining sufficient oxygen carrying capacity in blood, thereby improving patients health status. […] Iron supplement is necessary to restore lost iron from heavy menstrual bleeding. […] In order to measure the effectiveness of the nursing care plan, it is evaluated at the end of its course. Evaluation includes: Evaluate the patients timely recovery with decreased menstrual flow and restorations of lost iron supply. […] Abnormal Uterine Bleeding is a common yet critical disorder that needs the attention and apt medical care with the combination of medication, therapeutic, supportive and alternative approach for optimal health.

• #25 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] A member of your health care team will likely ask about your medical history and menstrual cycles. You may be asked to keep a diary to track days with and without bleeding. Record information such as how heavy your flow was and how many sanitary pads or tampons you needed to control it. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #26 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  Medicines for heavy menstrual bleeding may include: Nonsteroidal anti-inflammatory drugs, also called NSAIDs. NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), help reduce menstrual blood loss. NSAIDs may also make menstrual cramps less painful. […] If you have heavy menstrual bleeding from taking hormone medicine, you may need to stop or change your medicine. […] You may need surgery for heavy menstrual bleeding if medicines do not help. Treatment options include: Dilation and curettage, also called a DC. In this procedure, your doctor opens your cervix. This also is called dilating the cervix. The doctor then scrapes or suctions tissue from the lining of your uterus. […] After endometrial ablation, you may have much lighter periods. Pregnancy after endometrial ablation isn’t likely but is possible and could be dangerous. Using reliable or permanent birth control until menopause is recommended.

• #27 Heavy menstrual bleeding: diagnosis and management options – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/heavy-menstrual-bleeding-diagnosis-and-management-options

  Treatment for HMB should be offered when there is no other suspected pathology or when women are waiting for further investigations or definitive treatment. According to NICE, the recommended first-line treatment is a LNG-IUS if long-term management (≥12 months) is expected. A LNG-IUS (a progestogen) inhibits the endometrial synthesis of oestrogen, therefore preventing proliferation and, sometimes, ovulation. It may take at least six cycles to see the maximal benefits and, during this time, there can be changes in bleeding patterns that can last longer than six months. After one year of use, a LNG-IUS has been shown to decrease menstrual blood loss by up to 96%. It is not only cost effective, but is the option of choice when preservation of fertility is important. […] Recommended second-line treatment includes tranexamic acid, non-steroidal anti-inflammatory drugs (NSAIDs) and combined oral contraceptives (COCs). Tranexamic acid is an antifibrinolytic — a potent inhibitor of the activation of plasminogen to plasmin — which inhibits fibrinolysis, increases clot formation and reduces blood loss by up to 58%. The anti-inflammatory activity of NSAIDs and their inhibitory actions on PGs reduces bleeding by 49%. COCs contain both oestrogen and progesterone, and have been estimated to reduce blood loss by up to 50%.

• #28 Heavy menstrual bleeding: diagnosis and management options – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/heavy-menstrual-bleeding-diagnosis-and-management-options

  Treatment for HMB should be offered when there is no other suspected pathology or when women are waiting for further investigations or definitive treatment. According to NICE, the recommended first-line treatment is a LNG-IUS if long-term management (≥12 months) is expected. A LNG-IUS (a progestogen) inhibits the endometrial synthesis of oestrogen, therefore preventing proliferation and, sometimes, ovulation. It may take at least six cycles to see the maximal benefits and, during this time, there can be changes in bleeding patterns that can last longer than six months. After one year of use, a LNG-IUS has been shown to decrease menstrual blood loss by up to 96%. It is not only cost effective, but is the option of choice when preservation of fertility is important. […] Recommended second-line treatment includes tranexamic acid, non-steroidal anti-inflammatory drugs (NSAIDs) and combined oral contraceptives (COCs). Tranexamic acid is an antifibrinolytic — a potent inhibitor of the activation of plasminogen to plasmin — which inhibits fibrinolysis, increases clot formation and reduces blood loss by up to 58%. The anti-inflammatory activity of NSAIDs and their inhibitory actions on PGs reduces bleeding by 49%. COCs contain both oestrogen and progesterone, and have been estimated to reduce blood loss by up to 50%.

• #29 Heavy menstrual bleeding: assessment and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493300/

  If a woman with HMB declines an LNG-IUS or it is not suitable, consider the following pharmacological treatments: non-hormonal: tranexamic acid, NSAIDs; hormonal: combined hormonal contraception, cyclical oral progestogens. […] Be aware that progestogen-only contraception may suppress menstruation, which could be beneficial to women with HMB. […] If treatment is unsuccessful, the woman declines pharmacological treatment, or symptoms are severe, consider referral to specialist care for investigations to diagnose the cause of HMB, if needed. […] For women with submucosal fibroids, consider hysteroscopic removal. […] Consider referring women to specialist care to undertake additional investigations and discuss treatment options for fibroids of 3 cm or more in diameter. […] Advise women to continue using NSAIDs and/or tranexamic acid for as long as they are found to be beneficial.

• #30 Heavy menstrual bleeding // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/heavy-menstrual-bleeding

  Medicines for heavy menstrual bleeding may include: Nonsteroidal anti-inflammatory drugs, also called NSAIDs. NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), help reduce menstrual blood loss. […] You may need surgery for heavy menstrual bleeding if medicines do not help. Treatment options include: Dilation and curettage, also called a DC. In this procedure, your doctor opens your cervix. […] After endometrial ablation, you may have much lighter periods. Pregnancy after endometrial ablation isn’t likely but is possible and could be dangerous. Using reliable or permanent birth control until menopause is recommended. […] Sometimes heavy menstrual bleeding is a sign of another condition, such as thyroid disease. In those cases, treating the condition usually results in lighter periods.

• #31 Heavy menstrual bleeding: diagnosis and management options – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/heavy-menstrual-bleeding-diagnosis-and-management-options

  Treatment for HMB should be offered when there is no other suspected pathology or when women are waiting for further investigations or definitive treatment. According to NICE, the recommended first-line treatment is a LNG-IUS if long-term management (≥12 months) is expected. A LNG-IUS (a progestogen) inhibits the endometrial synthesis of oestrogen, therefore preventing proliferation and, sometimes, ovulation. It may take at least six cycles to see the maximal benefits and, during this time, there can be changes in bleeding patterns that can last longer than six months. After one year of use, a LNG-IUS has been shown to decrease menstrual blood loss by up to 96%. It is not only cost effective, but is the option of choice when preservation of fertility is important. […] Recommended second-line treatment includes tranexamic acid, non-steroidal anti-inflammatory drugs (NSAIDs) and combined oral contraceptives (COCs). Tranexamic acid is an antifibrinolytic — a potent inhibitor of the activation of plasminogen to plasmin — which inhibits fibrinolysis, increases clot formation and reduces blood loss by up to 58%. The anti-inflammatory activity of NSAIDs and their inhibitory actions on PGs reduces bleeding by 49%. COCs contain both oestrogen and progesterone, and have been estimated to reduce blood loss by up to 50%.

• #32 Heavy Menstrual Bleeding | Conditions & Treatments | UR Medicine

  https://www.urmc.rochester.edu/conditions-and-treatments/heavy-menstrual-bleeding

  Blood tests to check for anemia and to see how fast your blood clots […] Pap test to check for cancerous changes, infection, or inflammation by examining cells collected from the cervix […] Ultrasound to check for fibroids or other problems inside the uterus […] Biopsy to check for cancer or other abnormal tissue by examining a tissue sample from the uterine lining. […] Prostaglandin inhibitors. These non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin or ibuprofen, help reduce cramping and the amount you bleed. […] Birth control pills, which stop ovulation and result in lighter periods […] Progesterone, a type of hormone treatment. […] Ablation, to destroy the lining of the uterus to stop or reduce bleeding […] Resection, to remove the lining of the uterus […] Hysterectomy, removing the entire uterus […] Iron supplements to address anemia as a result of heavy loss of blood.

• #33 Nursing Care Plan for Abnormal Uterine Bleed – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-abnormal-uterine-bleed/

  Abnormal uterine bleed (AUB) is a common gynecological condition characterized by irregular, excessive, or prolonged bleeding from the uterus. It can significantly impact a womans quality of life and requires comprehensive nursing care to address the physical, emotional, and educational needs of the patient. […] The nursing assessment for abnormal uterine bleed (AUB) is a crucial step in understanding the patients condition, identifying potential underlying causes, and developing an individualized care plan. […] Nursing diagnoses are critical in identifying and addressing the specific needs of patients experiencing abnormal uterine bleeding (AUB). By formulating accurate nursing diagnoses, nurses can develop targeted interventions and prioritize care to promote patient well-being. […] Planning effective nursing interventions is vital in addressing the needs of patients experiencing abnormal uterine bleeding (AUB). A comprehensive nursing care plan tailored to the individual patients needs promotes optimal outcomes and supports the womans overall well-being.

• #34 Heavy menstrual bleeding: assessment and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493300/

  Consider starting pharmacological treatment for HMB without investigating the cause if the womans history and/or examination suggests a low risk of fibroids, uterine cavity abnormality, histological abnormality or adenomyosis. […] Offer outpatient hysteroscopy to women with HMB if their history suggests submucosal fibroids, polyps or endometrial pathology. […] Ensure that outpatient hysteroscopy services are organised and the procedure is performed according to best practice, including advising women to take oral analgesia before the procedure. […] Provide women with information about HMB and its management. […] Provide information about all possible treatment options for HMB and discuss these with the woman. […] Explain to women who are offered an LNG-IUS about anticipated changes in bleeding pattern, particularly in the first few cycles and maybe lasting longer than 6 months.

• #35 Heavy menstrual bleeding: assessment and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493300/

  Consider starting pharmacological treatment for HMB without investigating the cause if the womans history and/or examination suggests a low risk of fibroids, uterine cavity abnormality, histological abnormality or adenomyosis. […] Offer outpatient hysteroscopy to women with HMB if their history suggests submucosal fibroids, polyps or endometrial pathology. […] Ensure that outpatient hysteroscopy services are organised and the procedure is performed according to best practice, including advising women to take oral analgesia before the procedure. […] Provide women with information about HMB and its management. […] Provide information about all possible treatment options for HMB and discuss these with the woman. […] Explain to women who are offered an LNG-IUS about anticipated changes in bleeding pattern, particularly in the first few cycles and maybe lasting longer than 6 months.

• #36

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh4126

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have new or worse belly or pelvic pain. You have severe vaginal bleeding. You feel dizzy or light-headed, or you feel like you may faint. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You think you may be pregnant. Your bleeding gets worse. You do not get better as expected.

• #37 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] A member of your health care team will likely ask about your medical history and menstrual cycles. You may be asked to keep a diary to track days with and without bleeding. Record information such as how heavy your flow was and how many sanitary pads or tampons you needed to control it. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #38

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh4126

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have new or worse belly or pelvic pain. You have severe vaginal bleeding. You feel dizzy or light-headed, or you feel like you may faint. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You think you may be pregnant. Your bleeding gets worse. You do not get better as expected.

• #39 Heavy Menstrual Periods: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.heavy-menstrual-periods-care-instructions.uh4126

  With heavy menstrual periods, your bleeding may be heavier or last longer than normal. You may pass large blood clots and have to change sanitary pads or tampons often. Or your periods may last longer than 7 days. […] Heavy bleeding can be caused by not ovulating regularly. It can also be caused by other problems, such as fibroids (growths that aren’t cancer). If you are overweight, you may be more likely to have heavy menstrual periods. But in some cases, there may not be a specific cause for your heavy periods. […] Your doctor may recommend hormone treatments to slow or stop your periods. If you have a fibroid, your doctor may recommend surgery or other treatments to remove the growth. Because blood loss from heavy periods can make you very tired and weak (anemic), your doctor may recommend that you take extra iron.

• #40 Heavy Periods — Clinic for Women

  https://www.clinicforwomen.com/heavy-periods

  Heavy menstrual bleeding can significantly impact a woman’s quality of life, causing physical discomfort, social embarrassment, and emotional distress. […] Menorrhagia, or heavy periods, is defined as soaking through a pad or tampon every hour or needing to use double protection to control bleeding or if you bleed for more than 7 days (A normal period usually lasts 4 to 6 days). […] Heavy menstrual bleeding can be caused by a variety of factors: […] When you lose a lot of blood during your period, your iron levels can drop. This can cause anemia. Anemia can make you feel tired and weak. Call your doctor if you think you have anemia. […] In rare cases, heavy periods may be a sign of a serious problem, such as an infection or cancer. […] Your doctor will ask about your menstrual periods and may perform a pelvic exam. During the exam, your doctor will check for signs of disease, infection, and abnormal growths.

• #41 Women’s experiences of heavy menstrual bleeding and medical treatment: a qualitative study in primary care | British Journal of General Practice

  https://bjgp.org/content/73/729/e294

  Heavy menstrual bleeding (HMB) is common and can affect womens lives. […] Women reported the wide-ranging and debilitating impact of HMB on their lives. […] They could then be frustrated by lack of a medical explanation for HMB. […] Experiences of medical treatments varied considerably but were strongly influenced by the perceived quality of healthcare interactions with clinicians. […] Clinicians should be aware of the considerable challenges faced by women with HMB; widely differing experiences of, and influences on, their treatment; and the value of patient-centred communication in this context. […] Heavy menstrual bleeding (HMB) has been reported by 27-36% of women in surveys and is a common reason for consultation in primary care. […] Women had concerns about volume of blood loss with their HMB and its implications, experiencing iron-deficiency anaemia and related hair loss.

• #42 Women’s experiences of heavy menstrual bleeding and medical treatment: a qualitative study in primary care | British Journal of General Practice

  https://bjgp.org/content/73/729/e294

  Respondents highlighted how women not talking about HMB could reduce awareness and recognition of it as a problem that might be treatable. […] Women recognised this perseverance occurred in the context of continuing stigma and taboo about menstruation and HMB, which was not openly spoken about, or publicly portrayed, contributing to wider lack of awareness and knowledge among women generally that it could be helped. […] Women had experienced a profound and debilitating impact from HMB, affecting multiple aspects of their lives. […] Women most consistently had positive experiences of their treatment at presentation or subsequently, when they trusted their GP or gynaecologist and communication in these encounters was perceived to be good. […] A positive experience occurred where there was a relationship of trust and women felt fully informed in discussing what may work best for them as individuals. […] Women advocated raising awareness of HMB. […] Tackling the enduring taboo and stigma of menstruation and HMB remains a major challenge for improving womens care. […] For clinical practice, the findings emphasise the importance and value to women of patient-centred communication in this context.

• #43

  https://www.nursingcenter.com/cearticle?an=01938899-202302280-00001&Journal_ID=5188715&Issue_ID=6567565

  HMB is acutely managed based on severity. For adolescents presenting with normal vital signs and a hemoglobin level higher than 8 g/dL, guidelines are outlined in the „Chronic Management” section next. […] Hormonal medication is typically used as a first-line treatment to stabilize the endometrium and stop or diminish active bleeding. […] Chronic management starts after outpatient evaluation of HMB in a stable patient, or after hormonal medication is tapered to once-daily dosing after an acute intervention. […] The FIGO definition of HMB includes the impact on social and emotional well-being; thus, psychosocial support is important. […] Quality-of-life surveys from adolescents with HMB show that school is the most affected domain, manifesting as missed school days, decreased concentration and increased fatigue in class, decreased participation in sports and physical activity, increased feelings of isolation from peers, and anxiety. […] HMB negatively affects self-esteem, school attendance, and participation in sports, and results in an increase in anemia, iron deficiency, depression, fatigue, and emergency department utilization.

• #44 About Heavy Menstrual Bleeding | Bleeding Disorders in Women | CDC

  https://www.cdc.gov/female-blood-disorders/about/heavy-menstrual-bleeding.html

  Heavy menstrual bleeding, or menorrhagia, is menstrual bleeding (your period) that is very heavy during your period. It can be menstrual bleeding that lasts more than 7 days. […] If you have this type of bleeding, you should see a healthcare provider. […] Heavy menstrual bleeding is one of the most common problems women report to their healthcare provider. It affects more than 10 million American women each year. This means about 1 of every 5 women has it. […] Finding out if a woman has heavy menstrual bleeding often is not easy, because each person might think of „heavy bleeding” in a different way. […] Heavy menstrual bleeding is common among women. But many women do not know that they can get help for it. […] The type of treatment you get will depend on the cause of your bleeding and how serious it is. […] Some treatments are on-going, and others are done one time. You should discuss all your options with your healthcare provider to decide which is best for you. […] Talking openly with your healthcare provider is very important in making sure you are diagnosed properly and get the right treatment.

• #45 Heavy Menstrual Bleeding | Children’s Mercy Kansas City

  https://www.childrensmercy.org/health-care-providers/evidence-based-practice/cpgs-cpms-and-eras-pathways/heavy-menstrual-bleeding-care-process-model/

  Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. […] Heavy Menstrual Bleeding: ED/UCC Algorithm […] Heavy Menstrual Bleeding: Inpatient Algorithm […] Heavy Menstrual Bleeding: IV Premarin Algorithm […] Heavy Menstrual Bleeding Synopsis (provides care standards employed for this clinical pathway) […] Inclusion (any of the following): Volume equates to saturating a heavy absorbance pad/tampon more frequently than every 2 hours […] Excessive menstrual flow in duration of 7 days […] Bleeding is causing symptomatic anemia or lifestyle disturbance […] Bleeding is unlikely to be due to ongoing contraception […] These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time.

• #46 What will the ER do for heavy menstrual bleeding?

  https://www.medicalnewstoday.com/articles/what-will-er-do-for-heavy-menstrual-bleeding

  If a person is losing a lot of blood from a heavy period, and it is making them feel weak, dizzy, or sick, they should visit the emergency room (ER). Treatment may include medications to slow the bleeding, fluids, and, in some cases, blood transfusion. […] If the amount of bleeding is not a medical emergency but a person regularly experiences heavy periods, or menorrhagia, a doctor may refer someone to a gynecologist. […] A person should go to the ER if they have bleeding that soaks through one or more pads or tampons per hour over the course of several hours. […] When a person visits the ER due to heavy menstrual bleeding, the first priority is to make sure they are stable. […] Treatment for heavy bleeding first involves stabilizing the person and stopping the bleeding. […] If a person is unstable, a doctor will give IV fluids. They may also recommend a blood transfusion.

• #47 What will the ER do for heavy menstrual bleeding?

  https://www.medicalnewstoday.com/articles/what-will-er-do-for-heavy-menstrual-bleeding

  If a person is losing a lot of blood from a heavy period, and it is making them feel weak, dizzy, or sick, they should visit the emergency room (ER). Treatment may include medications to slow the bleeding, fluids, and, in some cases, blood transfusion. […] If the amount of bleeding is not a medical emergency but a person regularly experiences heavy periods, or menorrhagia, a doctor may refer someone to a gynecologist. […] A person should go to the ER if they have bleeding that soaks through one or more pads or tampons per hour over the course of several hours. […] When a person visits the ER due to heavy menstrual bleeding, the first priority is to make sure they are stable. […] Treatment for heavy bleeding first involves stabilizing the person and stopping the bleeding. […] If a person is unstable, a doctor will give IV fluids. They may also recommend a blood transfusion.

• #48 Abnormal Uterine Bleeding in Premenopausal Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0401/p435.html

  Abnormal uterine bleeding is a common symptom in women. […] Medical and surgical treatment options are available. Emergency interventions for severe bleeding that causes hemodynamic instability include uterine tamponade, intravenous estrogen, dilation and curettage, and uterine artery embolization. […] Patients with severe bleeding can be treated initially with oral estrogen, high-dose estrogen-progestin oral contraceptives, oral progestins, or intravenous tranexamic acid. […] The most effective long-term medical treatment for heavy menstrual bleeding is the levonorgestrel-releasing intrauterine system. […] Hysterectomy is the definitive treatment. […] A lower-risk surgical option is endometrial ablation, which performs as well as the levonorgestrel-releasing intrauterine system.

• #49 Abnormal Uterine Bleeding in Premenopausal Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0401/p435.html

  Abnormal uterine bleeding is a common symptom in women. […] Medical and surgical treatment options are available. Emergency interventions for severe bleeding that causes hemodynamic instability include uterine tamponade, intravenous estrogen, dilation and curettage, and uterine artery embolization. […] Patients with severe bleeding can be treated initially with oral estrogen, high-dose estrogen-progestin oral contraceptives, oral progestins, or intravenous tranexamic acid. […] The most effective long-term medical treatment for heavy menstrual bleeding is the levonorgestrel-releasing intrauterine system. […] Hysterectomy is the definitive treatment. […] A lower-risk surgical option is endometrial ablation, which performs as well as the levonorgestrel-releasing intrauterine system.

• #50 What will the ER do for heavy menstrual bleeding?

  https://www.medicalnewstoday.com/articles/what-will-er-do-for-heavy-menstrual-bleeding

  If the pregnancy test is positive, doctors will begin treating for a potential miscarriage. […] If the test is negative, they may administer additional treatments to stop the bleeding and reduce other symptoms. […] There are also surgical procedures that can reduce or stop heavy menstrual bleeding, such as dilation and curettage (D and C), which removes the top layer of uterine tissue. […] Some causes of heavy vaginal bleeding require long-term treatment or management. […] Each of these conditions has a different set of treatment options. […] Emergency treatments for uterine bleeding can depend on the cause, but may include estrogen and antifibrinolytic medications. […] Doctors typically define heavy menstrual bleeding as blood that soaks through one pad or tampon once an hour for several hours in a row.

• #51 Nursing care plan for abnormal uterine bleeding

  https://nursipedia.com/nursing-care-plan-abnormal-uterine-bleeding/

  Abnormal Uterine Bleeding (AUB) is a medical condition perceived as the excessive or prolonged bleeding from the uterus. It presents in form of irregular menstruation, prolonged uterine bleeding that can result in iron deficiency anemia, and heavy menstrual flow. […] The expected outcomes of AUB nursing care plan implies stabilizing bleeding pattern in the patient with possible corrective measure to avoid further bleeding amid abnormal uterine bleeding. It also implies maintaining sufficient oxygen carrying capacity in blood, thereby improving patients health status. […] Iron supplement is necessary to restore lost iron from heavy menstrual bleeding. […] In order to measure the effectiveness of the nursing care plan, it is evaluated at the end of its course. Evaluation includes: Evaluate the patients timely recovery with decreased menstrual flow and restorations of lost iron supply. […] Abnormal Uterine Bleeding is a common yet critical disorder that needs the attention and apt medical care with the combination of medication, therapeutic, supportive and alternative approach for optimal health.

• #52 Nursing care plan for abnormal uterine bleeding

  https://nursipedia.com/nursing-care-plan-abnormal-uterine-bleeding/

  Abnormal Uterine Bleeding (AUB) is a medical condition perceived as the excessive or prolonged bleeding from the uterus. It presents in form of irregular menstruation, prolonged uterine bleeding that can result in iron deficiency anemia, and heavy menstrual flow. […] The expected outcomes of AUB nursing care plan implies stabilizing bleeding pattern in the patient with possible corrective measure to avoid further bleeding amid abnormal uterine bleeding. It also implies maintaining sufficient oxygen carrying capacity in blood, thereby improving patients health status. […] Iron supplement is necessary to restore lost iron from heavy menstrual bleeding. […] In order to measure the effectiveness of the nursing care plan, it is evaluated at the end of its course. Evaluation includes: Evaluate the patients timely recovery with decreased menstrual flow and restorations of lost iron supply. […] Abnormal Uterine Bleeding is a common yet critical disorder that needs the attention and apt medical care with the combination of medication, therapeutic, supportive and alternative approach for optimal health.

• #53 Nursing care plan for abnormal uterine bleeding

  https://nursipedia.com/nursing-care-plan-abnormal-uterine-bleeding/

  Abnormal Uterine Bleeding (AUB) is a medical condition perceived as the excessive or prolonged bleeding from the uterus. It presents in form of irregular menstruation, prolonged uterine bleeding that can result in iron deficiency anemia, and heavy menstrual flow. […] The expected outcomes of AUB nursing care plan implies stabilizing bleeding pattern in the patient with possible corrective measure to avoid further bleeding amid abnormal uterine bleeding. It also implies maintaining sufficient oxygen carrying capacity in blood, thereby improving patients health status. […] Iron supplement is necessary to restore lost iron from heavy menstrual bleeding. […] In order to measure the effectiveness of the nursing care plan, it is evaluated at the end of its course. Evaluation includes: Evaluate the patients timely recovery with decreased menstrual flow and restorations of lost iron supply. […] Abnormal Uterine Bleeding is a common yet critical disorder that needs the attention and apt medical care with the combination of medication, therapeutic, supportive and alternative approach for optimal health.

• #54

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh4126

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have new or worse belly or pelvic pain. You have severe vaginal bleeding. You feel dizzy or light-headed, or you feel like you may faint. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You think you may be pregnant. Your bleeding gets worse. You do not get better as expected.

• #55 Heavy menstrual bleeding: assessment and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493300/

  Consider starting pharmacological treatment for HMB without investigating the cause if the womans history and/or examination suggests a low risk of fibroids, uterine cavity abnormality, histological abnormality or adenomyosis. […] Offer outpatient hysteroscopy to women with HMB if their history suggests submucosal fibroids, polyps or endometrial pathology. […] Ensure that outpatient hysteroscopy services are organised and the procedure is performed according to best practice, including advising women to take oral analgesia before the procedure. […] Provide women with information about HMB and its management. […] Provide information about all possible treatment options for HMB and discuss these with the woman. […] Explain to women who are offered an LNG-IUS about anticipated changes in bleeding pattern, particularly in the first few cycles and maybe lasting longer than 6 months.

• #56

  https://www.nursingcenter.com/cearticle?an=01938899-202302280-00001&Journal_ID=5188715&Issue_ID=6567565

  HMB is acutely managed based on severity. For adolescents presenting with normal vital signs and a hemoglobin level higher than 8 g/dL, guidelines are outlined in the „Chronic Management” section next. […] Hormonal medication is typically used as a first-line treatment to stabilize the endometrium and stop or diminish active bleeding. […] Chronic management starts after outpatient evaluation of HMB in a stable patient, or after hormonal medication is tapered to once-daily dosing after an acute intervention. […] The FIGO definition of HMB includes the impact on social and emotional well-being; thus, psychosocial support is important. […] Quality-of-life surveys from adolescents with HMB show that school is the most affected domain, manifesting as missed school days, decreased concentration and increased fatigue in class, decreased participation in sports and physical activity, increased feelings of isolation from peers, and anxiety. […] HMB negatively affects self-esteem, school attendance, and participation in sports, and results in an increase in anemia, iron deficiency, depression, fatigue, and emergency department utilization.

• #57

  https://www.nursingcenter.com/cearticle?an=01938899-202302280-00001&Journal_ID=5188715&Issue_ID=6567565

  Heavy menstrual bleeding (HMB) is a common problem in adolescents. Untreated HMB may result in deleterious medical, psychological, and social consequences. Patients often benefit from a multidisciplinary team, which can include an obstetrician/gynecologist, adolescent medicine specialist or pediatrician, hematologist, and mental health provider. […] The purpose of this article is to provide up-to-date guidance on evaluating, diagnosing, and managing HMB in adolescents. […] Medical complications of untreated HMB in adolescents include symptomatic iron deficiency with or without anemia, which may cause fatigue, weakness, and deficits in attention and concentration. […] Adolescents with HMB may present with severe iron-deficiency anemia, requiring blood transfusion, urgent care and emergency department visits, and hospitalization.

• #58 Nursing Care Plan for Abnormal Uterine Bleed – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-abnormal-uterine-bleed/

  A nursing care plan for abnormal uterine bleeding involves a comprehensive and patient-centered approach that addresses the physical, emotional, and educational aspects of care. By providing appropriate interventions, emotional support, education, and collaboration with the healthcare team, nurses play a vital role in promoting the well-being and quality of life of women with abnormal uterine bleeding.

• #59 Abnormal Menstrual Bleeding | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/abnormal-menstrual-bleeding/

  We consider a menstrual period to be heavy or abnormal if it lasts longer than eight days in a row. Heavy or abnormal menstrual periods also include bleeding that occurs more often than every three weeks and requires changing a pad or tampon every hour or less during menstruation. Heavy menstrual bleeding may also cause fatigue, dizziness or other signs of anemia. […] Heavy menstrual bleeding due to hormonal factors is more common in the first few years after getting a menstrual period. […] Heavy menstrual bleeding due to a bleeding disorder is often due to an inherited or genetic condition. […] Signs of anemia such as fatigue, shortness of breath or dizziness. […] In most cases, abnormal or heavy menstrual bleeding is due to a hormone imbalance. […] Treatment is different for each patient, but there are some common options.

• #60

  https://www.nursingcenter.com/cearticle?an=01938899-202302280-00001&Journal_ID=5188715&Issue_ID=6567565

  HMB is acutely managed based on severity. For adolescents presenting with normal vital signs and a hemoglobin level higher than 8 g/dL, guidelines are outlined in the „Chronic Management” section next. […] Hormonal medication is typically used as a first-line treatment to stabilize the endometrium and stop or diminish active bleeding. […] Chronic management starts after outpatient evaluation of HMB in a stable patient, or after hormonal medication is tapered to once-daily dosing after an acute intervention. […] The FIGO definition of HMB includes the impact on social and emotional well-being; thus, psychosocial support is important. […] Quality-of-life surveys from adolescents with HMB show that school is the most affected domain, manifesting as missed school days, decreased concentration and increased fatigue in class, decreased participation in sports and physical activity, increased feelings of isolation from peers, and anxiety. […] HMB negatively affects self-esteem, school attendance, and participation in sports, and results in an increase in anemia, iron deficiency, depression, fatigue, and emergency department utilization.

• #61 Heavy Periods: Causes, Symptoms and Treatment | 700 Children’s Blog

  https://www.nationwidechildrens.org/family-resources-education/700childrens/2016/10/heavy-menstrual-bleeding-what-girls-and-parents-need-to-know

  Many of the young women we see in our clinics have iron deficiency or iron deficiency anemia, a common complication of heavy menstrual bleeding. […] Dietary changes and use of oral iron supplements are always the first line of intervention for such patients. […] Encouraging teens to give their health care provider an accurate description of their menstrual cycles, and to freely share any concerns regarding the duration or heaviness of their menstrual bleeding, are the first steps to avoid delays in the diagnosis of bleeding disorders.

• #62 Heavy Periods: Causes, Symptoms and Treatment | 700 Children’s Blog

  https://www.nationwidechildrens.org/family-resources-education/700childrens/2016/10/heavy-menstrual-bleeding-what-girls-and-parents-need-to-know

  Heavy menstrual bleeding is a common problem during adolescence. […] Heavy menstrual bleeding can negatively impact quality of life, school attendance, and participation in after-school sports and activities. […] Patients and health care providers should consider a diagnosis of heavy menstrual bleeding when any of the following symptoms occur: Menses lasts more than seven days, Bleeding is heavy enough to soak through a pad or tampon in 1-2 hours. School attendance or sports/activity participation is impacted by the challenges of menstrual hygiene, Patient alters her social schedule or plan events according to her menstrual cycle, Patient has experienced flooding, with unexpected onset of flow like turning on a faucet or which includes the passage of clots larger than 1 inch in diameter (about the size of a grape), Menses associated with iron deficiency, with or without anemia.

• #63 Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/09/screening-and-management-of-bleeding-disorders-in-adolescents-with-heavy-menstrual-bleeding

  Heavy menstrual bleeding is defined as excessive menstrual blood loss that interferes with a woman’s physical, social, emotional, or material quality of life. […] Evaluation of adolescent girls who present with heavy menstrual bleeding should include assessment for anemia from blood loss, including serum ferritin, the presence of an endocrine disorder leading to anovulation, and evaluation for the presence of a bleeding disorder. […] The first-line approach to acute bleeding in the adolescent is medical management; surgery should be reserved for those who do not respond to medical therapy. […] Use of antifibrinolytics such as tranexamic acid or aminocaproic acid in oral and intravenous form may be used to stop bleeding. […] After correction of acute heavy menstrual bleeding, maintenance hormonal therapy can include combined hormonal contraceptives, oral and injectable progestins, and levonorgestrel-releasing intrauterine devices.

• #64 Heavy Menstrual Bleeding – Together by St. Jude™

  https://together.stjude.org/en-us/treatment-tests-procedures/symptoms-side-effects/heavy-menstrual-bleeding.html

  Heavy periods are common and affect about 1 in 5 women of reproductive age. […] Heavy menstrual bleeding can be a symptom of certain bleeding disorders such as von Willebrand disease, thrombocytopenia, platelet disorders, and hemophilia. […] Talk to your health care provider if you have symptoms of a bleeding disorder. […] Treatment for heavy menstrual bleeding will depend on the cause of bleeding and how serious it is. […] Treatment of heavy periods usually starts with medicine or hormonal therapies. […] In some cases, surgery may be needed. […] The prognosis for heavy menstrual bleeding depends on the underlying cause. […] Heavy menstrual bleeding can lead to iron deficiency anemia, which causes fatigue and other problems. […] Call your care team or go to the emergency room as soon as possible if you: Soak through a pad or tampon every hour for several hours, Use 2 pads or tampons every hour for 2 hours straight, Pass a blood clot that is larger than the size of a quarter, Have a period that lasts for more than 7 days, Feel dizzy, weak, extremely tired, or short of breath, Have extreme pain with your period. […] Treatment for heavy menstrual bleeding may include medicines, hormone therapies, or surgery. […] Keep track of your periods and discuss your symptoms with your health care provider so you can develop a plan to manage menstrual bleeding.

• #65 Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/09/screening-and-management-of-bleeding-disorders-in-adolescents-with-heavy-menstrual-bleeding

  Heavy menstrual bleeding is defined as excessive menstrual blood loss that interferes with a woman’s physical, social, emotional, or material quality of life. […] Evaluation of adolescent girls who present with heavy menstrual bleeding should include assessment for anemia from blood loss, including serum ferritin, the presence of an endocrine disorder leading to anovulation, and evaluation for the presence of a bleeding disorder. […] The first-line approach to acute bleeding in the adolescent is medical management; surgery should be reserved for those who do not respond to medical therapy. […] Use of antifibrinolytics such as tranexamic acid or aminocaproic acid in oral and intravenous form may be used to stop bleeding. […] After correction of acute heavy menstrual bleeding, maintenance hormonal therapy can include combined hormonal contraceptives, oral and injectable progestins, and levonorgestrel-releasing intrauterine devices.

• #66 Heavy menstrual bleeding: work-up and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6142441/

  Hemostatic therapy for HMB may serve as an alternative to hormonal or surgical therapy, and may even be life-saving when used to correct an abnormality of coagulation. […] The gynecologic and hematologic evaluation of HMB is summarized in Table 1. […] The patients evaluation will include a review of the history (menstrual, medical, bleeding, and medications), a review of the gynecologic evaluation, and a laboratory assessment for an underlying bleeding disorder. […] The goal of treatment is to reduce HMB. Not only will the treatment strategy depend on whether there is ovulatory dysfunction, uterine pathology, or an abnormality of coagulation, the treatment strategy will also depend on the age of the patient and her desire for immediate or long-term fertility. […] Hemostatic therapy for HMB may serve as an alternative to hormonal or surgical therapy, or be used to correct a coagulation defect. […] The general approach to the management of acute HMB, defined as HMB requiring emergency treatment, in a patient with a disorder of hemostasis requires the combined efforts of the gynecologist and the hematologist.

• #67 How bleeding disorders can affect women | The Haemophilia Society

  https://haemophilia.org.uk/support/talking-red/women-with-bleeding-disorders/

  Heavy, prolonged periods are the most common symptom for women with bleeding disorders (called menorrhagia). […] Women with bleeding disorders should be checked regularly for anaemia. Iron supplements may be prescribed for this. […] Living with heavy periods should not be dismissed as being a minor issue. Heavy periods can have a dramatic effect on a womans health, her sense of well-being and her ability to work. […] GPs have a vital role to play in signposting women to the right specialist care and can offer immediate help by prescribing tranexamic acid which will help with heavy menstrual bleeding, regardless of the diagnosis. […] Heavy periods (menorrhagia) are common in women with bleeding disorders. […] If your period lasts for more than 7-days, you are soaking through sanitary protection every 2 hours or less or your clots are bigger than a 50p piece then you should contact your haemophilia centre.

• #68 Heavy menstrual bleeding: work-up and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6142441/

  Hemostatic therapy for HMB may serve as an alternative to hormonal or surgical therapy, and may even be life-saving when used to correct an abnormality of coagulation. […] The gynecologic and hematologic evaluation of HMB is summarized in Table 1. […] The patients evaluation will include a review of the history (menstrual, medical, bleeding, and medications), a review of the gynecologic evaluation, and a laboratory assessment for an underlying bleeding disorder. […] The goal of treatment is to reduce HMB. Not only will the treatment strategy depend on whether there is ovulatory dysfunction, uterine pathology, or an abnormality of coagulation, the treatment strategy will also depend on the age of the patient and her desire for immediate or long-term fertility. […] Hemostatic therapy for HMB may serve as an alternative to hormonal or surgical therapy, or be used to correct a coagulation defect. […] The general approach to the management of acute HMB, defined as HMB requiring emergency treatment, in a patient with a disorder of hemostasis requires the combined efforts of the gynecologist and the hematologist.

• #69 #280 Heavy Menstrual Bleeding, Anticoagulation & Coagulopathy in Menstruating Patients – The Curbsiders

  https://thecurbsiders.com/curbsiders-podcast/280

  Hormonal Therapy, Venous thromboembolic disease, Anticoagulation, and Abnormal Uterine Bleeding with Dr. Bethany Samuelson Bannow […] Explore the intersection of hematology and women’s health as we discuss heavy menstrual bleeding (HMB), gynecologic risks of therapeutic anticoagulation, and prescribing contraception in the setting of venous thromboembolic disease. […] This episode will empower you to tackle the stigma and overcome knowledge gaps with regard to abnormal menstrual bleeding, as well as learn treatment, and management pearls. […] Approximately 20% of patients with heavy menstrual bleeding will have a bleeding diathesis, including non-specific platelet dysfunction, von Willebrand’s disease, or hemophilia carrier state. […] Rivaroxaban is confirmed to have a higher menstrual bleeding risk than vitamin K antagonists, which can also lead to interruption of therapy and risk of recurrent VTE.

• #70 #280 Heavy Menstrual Bleeding, Anticoagulation & Coagulopathy in Menstruating Patients – The Curbsiders

  https://thecurbsiders.com/curbsiders-podcast/280

  Provide anticipatory guidance about heavy bleeding, and management options when starting anticoagulation. […] Empower women to report any abnormal bleeding while on anticoagulation–minimize the risk of a patient self-discontinuing therapy and increasing the risk of recurrent VTE. […] Dr. Samuelson Bannow estimates that approximately 20% of patients with HMB will have an underlying bleeding disorder. […] Have a conversation with your patient! Discuss the risk of heavy menstrual bleeding when starting therapy, and engage in patient centered care regarding choice of a BID or once daily DOAC.

• #71 #280 Heavy Menstrual Bleeding, Anticoagulation & Coagulopathy in Menstruating Patients – The Curbsiders

  https://thecurbsiders.com/curbsiders-podcast/280

  Certain contraceptives, especially long acting reversible contraceptives (LARC), can be used to lessen heavy menstrual bleeding caused by therapeutic anticoagulation, as well as hemostatic agents. […] Tranexamic acid DOES NOT CAUSE CLOTS and can be valuable for HMB (ex. 1300mg TID for 5 days). […] Treatment rule number 1: Treat the iron deficiency! […] Treatment rule number 2: Treat the bleeding! Tranexamic acid DOES NOT CAUSE CLOTS and can be valuable for HMB (ex. 1300mg TID for 5 days). […] Contraception options can be used to manage HMB, especially intrauterine devices with levonorgestrel (do NOT use a copper IUD to control HMB!). […] In addition to bleeding predilection, there may be structural abnormalities or other primary gynecologic pathology contributing to heavy menstrual bleeding.

• #72 #280 Heavy Menstrual Bleeding, Anticoagulation & Coagulopathy in Menstruating Patients – The Curbsiders

  https://thecurbsiders.com/curbsiders-podcast/280

  Provide anticipatory guidance about heavy bleeding, and management options when starting anticoagulation. […] Empower women to report any abnormal bleeding while on anticoagulation–minimize the risk of a patient self-discontinuing therapy and increasing the risk of recurrent VTE. […] Dr. Samuelson Bannow estimates that approximately 20% of patients with HMB will have an underlying bleeding disorder. […] Have a conversation with your patient! Discuss the risk of heavy menstrual bleeding when starting therapy, and engage in patient centered care regarding choice of a BID or once daily DOAC.

• #73 #280 Heavy Menstrual Bleeding, Anticoagulation & Coagulopathy in Menstruating Patients – The Curbsiders

  https://thecurbsiders.com/curbsiders-podcast/280

  Provide anticipatory guidance about heavy bleeding, and management options when starting anticoagulation. […] Empower women to report any abnormal bleeding while on anticoagulation–minimize the risk of a patient self-discontinuing therapy and increasing the risk of recurrent VTE. […] Dr. Samuelson Bannow estimates that approximately 20% of patients with HMB will have an underlying bleeding disorder. […] Have a conversation with your patient! Discuss the risk of heavy menstrual bleeding when starting therapy, and engage in patient centered care regarding choice of a BID or once daily DOAC.

• #74

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh4126

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have new or worse belly or pelvic pain. You have severe vaginal bleeding. You feel dizzy or light-headed, or you feel like you may faint. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You think you may be pregnant. Your bleeding gets worse. You do not get better as expected.

• #75 Heavy menstrual bleeding – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829

  Seek medical help before your next scheduled exam if you have: Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than two hours in a row. Bleeding between periods or unusual vaginal bleeding. Vaginal bleeding after menopause. […] In some cases, the reason for heavy menstrual bleeding is unknown. But a number of conditions may cause heavy menstrual bleeding. They include: Hormones being out of balance. In a typical menstrual cycle, there’s a balance between the hormones estrogen and progesterone. This controls the buildup of the lining of the uterus. The lining of the uterus also is known as the endometrium. This lining is shed during a menstrual period. When hormones are out of balance, the lining becomes too thick and sheds by way of heavy menstrual bleeding or unexpected bleeding between periods.

• #76

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh4126

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have new or worse belly or pelvic pain. You have severe vaginal bleeding. You feel dizzy or light-headed, or you feel like you may faint. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You think you may be pregnant. Your bleeding gets worse. You do not get better as expected.

• #77

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh4126

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have new or worse belly or pelvic pain. You have severe vaginal bleeding. You feel dizzy or light-headed, or you feel like you may faint. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You think you may be pregnant. Your bleeding gets worse. You do not get better as expected.

• #78 Heavy menstrual bleeding // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/heavy-menstrual-bleeding

  Seek medical help before your next scheduled exam if you have: Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than two hours in a row. Bleeding between periods or unusual vaginal bleeding. Vaginal bleeding after menopause. […] Heavy menstrual bleeding can cause anemia related to blood loss. Anemia is a condition in which the body lacks enough red blood cells to carry oxygen to tissues. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #79 Heavy menstrual bleeding // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/heavy-menstrual-bleeding

  Seek medical help before your next scheduled exam if you have: Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than two hours in a row. Bleeding between periods or unusual vaginal bleeding. Vaginal bleeding after menopause. […] Heavy menstrual bleeding can cause anemia related to blood loss. Anemia is a condition in which the body lacks enough red blood cells to carry oxygen to tissues. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #80 Nursing Care Plan for Abnormal Uterine Bleed – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-abnormal-uterine-bleed/

  A nursing care plan for abnormal uterine bleeding involves a comprehensive and patient-centered approach that addresses the physical, emotional, and educational aspects of care. By providing appropriate interventions, emotional support, education, and collaboration with the healthcare team, nurses play a vital role in promoting the well-being and quality of life of women with abnormal uterine bleeding.

• #81 Heavy menstrual bleeding – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

  During hysteroscopy (his-tur-OS-kuh-pee), a thin, lighted instrument provides a view of the inside of the uterus. This instrument also is called a hysteroscope. […] A member of your health care team will likely ask about your medical history and menstrual cycles. You may be asked to keep a diary to track days with and without bleeding. Record information such as how heavy your flow was and how many sanitary pads or tampons you needed to control it. […] Your doctor can make a diagnosis of heavy menstrual bleeding or abnormal uterine bleeding only after it’s known that something else isn’t causing your condition. These causes may include menstrual disorders, medical conditions or medicines. […] Treatment for heavy menstrual bleeding is based on a number of factors. These include: Your overall health and medical history. The cause of the condition and how serious it is. How well you tolerate certain medicines or procedures. The chance that your periods will soon become less heavy. Your plans to have children. How the condition affects your lifestyle. Your opinion or personal choices.

• #82 Heavy menstrual bleeding: assessment and management – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493300/

  Consider starting pharmacological treatment for HMB without investigating the cause if the womans history and/or examination suggests a low risk of fibroids, uterine cavity abnormality, histological abnormality or adenomyosis. […] Offer outpatient hysteroscopy to women with HMB if their history suggests submucosal fibroids, polyps or endometrial pathology. […] Ensure that outpatient hysteroscopy services are organised and the procedure is performed according to best practice, including advising women to take oral analgesia before the procedure. […] Provide women with information about HMB and its management. […] Provide information about all possible treatment options for HMB and discuss these with the woman. […] Explain to women who are offered an LNG-IUS about anticipated changes in bleeding pattern, particularly in the first few cycles and maybe lasting longer than 6 months.

• #83

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh4126

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have new or worse belly or pelvic pain. You have severe vaginal bleeding. You feel dizzy or light-headed, or you feel like you may faint. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You think you may be pregnant. Your bleeding gets worse. You do not get better as expected.

• #84 About Heavy Menstrual Bleeding | Bleeding Disorders in Women | CDC

  https://www.cdc.gov/female-blood-disorders/about/heavy-menstrual-bleeding.html

  Heavy menstrual bleeding, or menorrhagia, is menstrual bleeding (your period) that is very heavy during your period. It can be menstrual bleeding that lasts more than 7 days. […] If you have this type of bleeding, you should see a healthcare provider. […] Heavy menstrual bleeding is one of the most common problems women report to their healthcare provider. It affects more than 10 million American women each year. This means about 1 of every 5 women has it. […] Finding out if a woman has heavy menstrual bleeding often is not easy, because each person might think of „heavy bleeding” in a different way. […] Heavy menstrual bleeding is common among women. But many women do not know that they can get help for it. […] The type of treatment you get will depend on the cause of your bleeding and how serious it is. […] Some treatments are on-going, and others are done one time. You should discuss all your options with your healthcare provider to decide which is best for you. […] Talking openly with your healthcare provider is very important in making sure you are diagnosed properly and get the right treatment.

• #85 Nursing Care Plan for Abnormal Uterine Bleed – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-abnormal-uterine-bleed/

  A nursing care plan for abnormal uterine bleeding involves a comprehensive and patient-centered approach that addresses the physical, emotional, and educational aspects of care. By providing appropriate interventions, emotional support, education, and collaboration with the healthcare team, nurses play a vital role in promoting the well-being and quality of life of women with abnormal uterine bleeding.

• #86 Women’s experiences of heavy menstrual bleeding and medical treatment: a qualitative study in primary care | British Journal of General Practice

  https://bjgp.org/content/73/729/e294

  Respondents highlighted how women not talking about HMB could reduce awareness and recognition of it as a problem that might be treatable. […] Women recognised this perseverance occurred in the context of continuing stigma and taboo about menstruation and HMB, which was not openly spoken about, or publicly portrayed, contributing to wider lack of awareness and knowledge among women generally that it could be helped. […] Women had experienced a profound and debilitating impact from HMB, affecting multiple aspects of their lives. […] Women most consistently had positive experiences of their treatment at presentation or subsequently, when they trusted their GP or gynaecologist and communication in these encounters was perceived to be good. […] A positive experience occurred where there was a relationship of trust and women felt fully informed in discussing what may work best for them as individuals. […] Women advocated raising awareness of HMB. […] Tackling the enduring taboo and stigma of menstruation and HMB remains a major challenge for improving womens care. […] For clinical practice, the findings emphasise the importance and value to women of patient-centred communication in this context.

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