REDUCED MENSTRUAL FLOW: INVESTIGATIONS AND TREATMENT

CONTENT

-INVESTIGATIONS

-TREATMENT

 

INVESTIGATIONS

Below are some of the investigations necessary for making a proper diagnosis of the specific causes of reduced or scanty menstrual flow.

SERUM PREGNANCY HORMONE TEST

Because pregnancy is one of the commonest cause of both absent menses and abnormal vaginal bleeding, it is important to exclude pregnancy as a cause of either secondary amenorrhea or of any abnormal vaginal bleeding by doing a blood pregnancy test for all women with such complaints.

PROGESTERONE CHALLENGE TEST

In women with secondary amenorrhea or abnormal vaginal bleeding, progesterone analogues can be given for about 7 to 10 days or a pack of oral contraceptive pills for one cycle  to challenge the endometrium or to assess the integrity of the endometrium. If a normal vaginal bleeding (medically termed withdrawal bleeding) occur within some few days after finishing the drugs, then the woman has a normal endometrial linning with no damage done to it, suggesting that she has PCOS and not uterine synechiea, but if there remains little or no bleeding after the medications, then the woman either has a damage to the endometrial lining of her womb, or her womb has not been exposed to oestrogen in a long time suggesting menopause or other causes of reduced or low oestrogen level. 

PELVIC ULTRASOUND

This is a non invasive investigation used in demonstrating the collection of blood within the uterus and the vagina in women with haematometra and haematocolpos due to cervical stenosis and vaginal gynaetresia respectively during the menstrual phase of the menstrual cycle.

HYSTEROSALPINGOGRAPHY (HSG)

This is an invasive procedure involved with the injection of a contrast dye into the female genital tract, followed by an X-ray to outline the cervical canal, the uterine cavity and the patency of the fallopian tube during assessment of a woman for either or for both uterine synechiae and tubal factor infertility. Women with uterine synechiae or Asherman syndrome will have filling defects seen as obliteration of the normal uterine cavity on the X-ray film. 

HYSTEROSCOPY

This is an endoscopic procedure used in direct visualization of the endometrial or uterine cavity. Through it, the actual extent and the location of the fibrous or scar tisssues are seen and in expert hands dissected to restore the normal anatomy of the uterine cavity.

ENDOMETRIAL BIOPSY AND CULTURE

This is a rare test, indicated in rare instances where TB endometritis i.e tuberculosis of the womb is suspected. It involves the sampling of the endometrium and sending the retrieved sample to the laboratory for the growth of the organism and confirmation of the disease.

 

TREATMENT

Generally, the aim of treatment is to excise or remove the scar tissues and encourage proper healing with normal tissues, while preventing the formation of new scar tissues from the raw surfaces initially involved in the scar formation. This is achieved in most cases by the dissection of the scar tissues holding the involved surfaces together. Thereafter, a barrier is placed between the separated raw surfaces from which the scar tissues were removed or dissected. In some cases, some medications may be given to encourage the proper healing of the separated surfaces with normal tissues in order to avoid reformation of scar tissues between the separated surfaces. The treatment and complications of each and specific cause of reduced and absent menses will be discussed in articles written on each of them on this site. For more information, please CHAT WITH OUR CONSULTANTS .

 

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