Menstrual Disorders

Dec 1, 2019 Issue
Combined Hormonal Contraceptives for Heavy Menstrual Bleeding [Cochrane for Clinicians]

Combined oral contraceptives decrease the number of women reporting menorrhagia over six months compared with placebo (absolute risk reduction = 36.7%; number needed to treat = 2.7).

Jul 1, 2019 Issue
Amenorrhea: A Systematic Approach to Diagnosis and Management [Article]

Many underlying conditions can lead to amenorrhea. Primary amenorrhea is the failure to reach menarche. Secondary amenorrhea is the cessation of regular menses for three months or the cessastion of irregular menses for six months. Pregnancy should be excluded in all cases, as well as an evaluation that includes a history, physical examination, and laboratory assessment of serum hormone levels. Treatment should address the underlying cause.

Jul 1, 2017 Issue
Surgery vs. Medical Therapy for Heavy Menstrual Bleeding [Cochrane for Clinicians]

In women of reproductive age with chronic heavy menstrual bleeding, hysterectomy is the most effective treatment for controlling symptoms. Conservative surgery is more effective for controlling bleeding symptoms at one and two years than oral medications or the levonorgestrel-releasing intrauterine system, but by five years there is no difference.

Aug 1, 2016 Issue
Premenstrual Syndrome and Premenstrual Dysphoric Disorder [Article]

Get the latest diagnostic criteria for premenstrual syndrome and premenstrual dysphoric disorder, and find out which treatments have the best evidence of effectiveness.

Jun 15, 2014 Issue
ACOG Releases Guidelines on Management of Abnormal Uterine Bleeding Associated with Ovulatory Dysfunction [Practice Guidelines]

Abnormal uterine bleeding related to ovulatory dysfunction (i.e., oligo-ovulation and anovulation) is a range of disorders often associated with heavy, irregular bleeding. The American College of Obstetricians and Gynecologists (ACOG) treatment recommendations are based on the assumption that a phys...

Mar 1, 2014 Issue
Diagnosis and Initial Management of Dysmenorrhea [Article]

Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients’ quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the cause. Primar...

Jun 1, 2013 Issue
Amenorrhea: An Approach to Diagnosis and Management [Article]

Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition is failure t...

Jan 15, 2013 Issue
Evaluation and Treatment of Endometriosis [Article]

Endometriosis, which affects up to 10 percent of reproductive-aged women, is the presence of endometrial tissue outside of the uterine cavity. It is more common in women with pelvic pain or infertility (25 to 40 percent and 70 to 90 percent, respectively). Some women with endometriosis are asymptoma...

Feb 15, 2012 Issue
Dysmenorrhea [Clinical Evidence Handbook]

What are the effects of treatments for primary dysmenorrhea?

Jan 1, 2012 Issue
Evaluation and Management of Abnormal Uterine Bleeding in Premenopausal Women [Article]

Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the endometrium, an...

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