How does the etiology of menorrhagia vary by age?

Updated: Dec 20, 2018
  • Author: Julia A Shaw, MD, MBA, FACOG; Chief Editor: Michel E Rivlin, MD  more...
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Answer

Young patients, from menarche to the late-teen years, most commonly have anovulatory bleeding due to the immaturity of their hypothalamic-pituitary axis. If bleeding does not respond to usual therapy in this age group, a bleeding disorder must be considered.

Women aged 30-50 years may have organic or structural abnormalities. Fibroids or polyps are frequent anatomical findings. Organic causes can be anything from thyroid dysfunction to renal failure.

Postmenopausal women with any uterine bleeding should receive an immediate workup for endometrial cancer.

Endometrial hyperplasia must be considered in women who are obese, aged 70 or older, nulliparous, or have diabetes.


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