Sangramento uterino disfuncional

Abstract

Arq Bras Endocrinol Metab vol 45 nº 4 Agosto 2001 375 RESUMOBaseado em longa experiência clínica, o autor faz uma análise crítica da terminologia e conceituação das perdas sangüíneas uterinas irregulares. Destaca a freqüente confusão acadêmica entre os termos sangramento uterino disfuncional e sangramento uterino anormal, o que gera discussões acerca do diagnóstico e tratamento destas patologias. Procura racionalizar e simplificar a investigação clínica, enfatizando os recursos disponíveis em qualquer serviço ou consultório. Para tal, procura responder basicamente a duas questões: 1) O sangramento é de causa orgânica ou endócrina? 2) Se for de causa endócrina, é ovulatório ou anovulatório? Da mesma forma, limita o tratamento a dois ou três esquemas simples e eficazes, que funcionam também como diagnóstico diferencial ou tratamento de prova, pois, se um esquema racional, baseado no conhecimento da fisiopatologia do processo, não corrigir o sangramento, ele certamente não terá uma causa endócrina. Este fato nos obrigará a aprofundar a nossa propedêutica para identificar a causa orgânica. ABSTRACTBased on a long clinical experience, the author makes a critical analysis of the terminology and concept of irregular uterine bleeding. He highlights the frequent academic confusion concerning the terms dysfunctional uterine bleeding and abnormal uterine bleeding, which raises questions on the diagnosis and treatment of these pathologies. The author tries to rationalize and to simplify the clinical investigation emphasizing the common procedures available in any office. For such aim, we should answer two basic questions: Is the bleeding originated from an organic or endocrine cause? If endocrine, is it ovulatory or anovulatory? By the same token, the treatment is limited to two or three simple and efficient schemes that work also as a differential diagnostic tool. If a rational hormonal scheme, based on the knowledge of the physiopathology of the process, doesn't stop the bleeding, it certainly is not from an endocrine cause. This fact will force us to improve our investigation to identify the specific organic cause. (Arq Bras Endocrinol Metab 2001;45/4:375-382)

Alterações menstruais em pacientes com lúpus eritematoso sistêmico sob uso de imunossupressores

“…The dysfunctional uterine hemorrhage that has an anovulatory cause is more frequent at the extremes of the reproductive life -in the early menarche and in the perimenopausal period -with 20% occurring in adolescence and Bras J Rheumatol 2010;50(5):501-15 50% occurring at menopause; of the ones that have an ovulatory cause, 30% of them occur in menacme. 14 In our study 69.8% of the patients that presented menstrual alterations were 20 to 35 years. As our study did not include patients older than 40 years, an age at which physiological menopause is not yet established, does not have the capacity to offer conclusions on the correlations of these characteristics.…”

“…• Hypermenorrhea, with menstrual bleeding for more than seven days; • Menorrhagia, with a volume of bleeding > 80 mL during the menstrual period; • Polymenorrhea, in case of bleeding within an interval < 18 days; • Hypomenorrhea, when the menstrual period lasts < 3 days; • Oligomenorrhea, when there is an interval > 45 days between menstrual periods; • Secondary amenorrhea, when there is an interval > 90 days between the bleeding episodes after the occurrence of menarche. 14 The normality of the uterine and ovarian anatomy, in order to consider the hemorrhage as dysfunctional, was also evaluated by ultrasonography. A normal uterine volume was considered as the one between 30 and 120 cm³, using as the measuring method the product of the longitudinal, antero-posterior and lateral diameters by the constant 0.5233 (calculation of volume as of an ellipsoid structure).…”

Abnormal uterine bleeding and chronic iron deficiency

“…Intravenous conjugated estrogen 25 mg every four to six hours for the first 24 hours is suggested, followed by a combination of estrogen and progestin for the following days. 1 4 6 Combined oral contraceptives (COCs), more widely available in our country, can also be used to treat acute AUB. A COC with 35 mcg of ethinyl estradiol (or other combination of pills to achieve this dose) three times a day for seven days is indicated.…”

Efeitos Do Tratamento Manipulativo Osteopático Sobre Cicatrizes Abdominais: Relato De Caso

“…No entanto, estudos tem enfatizado a relação entre cicatriz cesariana com dores pélvicas e alterações no posicionamento do útero devido a fáscia sacro-retogenito-vesico-púbica 3 . Outros citam a retroversão uterina como fator corroborante à congestão do útero, sendo uma possível causa da hipermenorreia 4 . Sendo assim, este estudo teve como objetivo relatar os resultados obtidos com TMO em uma paciente que apresentava crises de lombociatalgia durante período menstrual, bem como sangramento uterino anormal.…”