ABSTRACT
Essential facts Heavy menstrual bleeding (HMB) is defined as excessive menstrual blood loss that interferes with a woman's physical, emotional, social or material quality of life. In England and Wales, around 80,000 women a year will be referred for the first time to secondary care, with 30,000 requiring surgical treatment.
Subject(s)
Menorrhagia/nursing , Quality of Life , England , Female , Humans , United Kingdom , WalesABSTRACT
Heavy menstrual bleeding, or menorrhagia, af ects approximately one-third of women. Treatments have included nonsteroidal anti-inflammatories and oral contraceptives, although neither is approved by the Food and Drug Administration (FDA) specifically for this use. Lysteda® (tranexamic acid) has recently been approved as a treatment for heavy menstrual bleeding. This article gives a background on menorrhagia and describes treatment with tranexamic acid, including its implications for nurses.
Subject(s)
Antifibrinolytic Agents/therapeutic use , Drug Approval , Menorrhagia/drug therapy , Tranexamic Acid/therapeutic use , Antifibrinolytic Agents/adverse effects , Female , Humans , Menorrhagia/nursing , Tranexamic Acid/adverse effects , Treatment Outcome , United States , United States Food and Drug AdministrationABSTRACT
BACKGROUND: For many woman who suffer from menorrhagia, treatment would previously have meant hysterectomy. Today there are a number of less invasive surgical options available, such as endometrial ablation, which involves removal of the endometrium and part of the myometrium. This article compares two endometrial ablative techniques--transcervical resection of the endometrium and thermal balloon therapy--with hysterectomy in the management of menorrhagia. CONCLUSION: While satisfaction with outcome is generally higher in women undergoing hysterectomy, satisfaction is also high following ablation and the procedure is less invasive and safer. Further research is required, however, to evaluate the long-term efficacy of ablation when compared to hysterectomy.
Subject(s)
Catheter Ablation , Hysterectomy , Menorrhagia/surgery , Patient Selection , Catheter Ablation/adverse effects , Catheter Ablation/methods , Catheter Ablation/psychology , Female , Humans , Hysterectomy/adverse effects , Hysterectomy/methods , Hysterectomy/psychology , Menorrhagia/nursing , Nurse's Role , Patient Education as Topic , Patient Satisfaction , Treatment OutcomeABSTRACT
Menarche is an important event during adolescence. For most girls, it marks completion of puberty and the onset of reproductive capability. Menarche usually occurs when both breast and pubic hair development are at Tanner stage 4. Menstrual problems are common during adolescence due to slow maturation of the hypothalamic-pituitary-ovarian axis and can last 2 to 5 years after menarche. Although most problems are explained by anovulation, other causes must be considered and excluded in a logical and cost-effective manner. Frequently, the bleeding problems observed in adolescence require evaluation and intervention.
Subject(s)
Menorrhagia , Menstrual Cycle , Puberty , Adolescent , Body Composition , Bone Development , Breast/growth & development , Diagnosis, Differential , Female , Hair/growth & development , Humans , Menorrhagia/etiology , Menorrhagia/nursing , Menorrhagia/physiopathology , Menorrhagia/prevention & control , Time Factors , United StatesABSTRACT
In the United States, as many as two million women (ie, 22%) each year will consult a physician about menorrhagia (ie, excessive menstrual bleeding). Seven hundred thousand hysterectomies are performed in the United States each year for symptomatic menorrhagia. The procedure cost, risk, and complications, combined with the fact that a large number of posthysterectomy specimens show no abnormality, suggest that the majority of hysterectomies performed for menorrhagia are unnecessary. These data suggest that a less invasive procedure that destroys the endometrial lining but preserves the uterus would be a beneficial procedure for patients with excessive uterine bleeding. Treatment for menorrhagia may include hormone therapy, endometrial curettage, endometrial ablation, and hysterectomy. Women who are opposed to hysterectomy and those for whom other treatment options were unsuccessful can consider ablation rather than hysterectomy.
Subject(s)
Catheter Ablation/nursing , Endometrium/surgery , Hysterectomy , Menorrhagia/therapy , Catheter Ablation/adverse effects , Catheter Ablation/methods , Catheterization/methods , Electrosurgery/adverse effects , Electrosurgery/methods , Electrosurgery/nursing , Female , Hot Temperature/therapeutic use , Humans , Hysterectomy/statistics & numerical data , Menorrhagia/nursing , Menorrhagia/surgery , Perioperative Nursing/methods , Unnecessary ProceduresABSTRACT
Each year, 600,000 hysterectomies are performed in the United States, costing an estimated $4 billion. Approximately 50% of these hysterectomies are performed for menorrhagia or abnormal uterine bleeding. Menorrhagia can have a negative impact on a woman's lifestyle and self-perception, often leading her to seek definitive treatment. Pharmacologic treatment for menorrhagia is not always successful, and dilatation and curettage provides relief for only the first few menstrual cycles. Surgical options include hysterectomy and two forms of endometrial ablation. Current research demonstrates that thermal uterine balloon therapy is the safest of these options. Uterine balloon therapy, an outpatient procedure, has resulted in successful reduction in menstrual flow in 70% to 90% of patients, and it soon may be performed as an office-based procedure.
Subject(s)
Catheterization/nursing , Menorrhagia/nursing , Menorrhagia/therapy , Perioperative Nursing , Catheter Ablation , Catheterization/methods , Chronic Disease , Endometrium , Female , Hot Temperature , Humans , Hysterectomy , Menorrhagia/etiology , Middle Aged , Perioperative Nursing/methodsABSTRACT
Menorrhagia is characterized by excessive menstrual bleeding and is defined as a menstrual blood loss of greater than 80 mL. Approximately one in ten women in the United States experiences menorrhagia. Although rarely life-threatening, menorrhagia can have a negative impact on women's lives, and its treatment can improve the quality of life for many women with this condition. This article reviews the definition, diagnosis, pathophysiology, assessment, and treatment of menorrhagia as well as the impact of menorrhagia and its treatment on the quality of life for women with this condition. The role of the midwife in the care of the woman with menorrhagia is also reviewed.
