Metrorrhagia | Uterus

Laura Miller MD

Definition

Metrorrhagia is uterine bleeding between menses with multifactorial causes including benign endometrial and cervical polyps, as well as endometrial and cervical cancers.

The result is uterine bleeding between menses in an amount less than or equal to menstrual flow.

Structural and functional changes vary depending on cause. Women present clinically due to their bleeding between menses.

Diagnosis is based on clinical history and treatment depends on the cause found at evaluation.

Prolapsing Submucosal Fibroid

This patient presented to the emergency room with severe crampy abdominal pain and a known history of a submucosal fibroid. The MRI shows the fibroid (dark pink) orotruding and expanding the cervix in the sagital view, and in the coronal view it is seen as a hyperemic structure (c) surrounded by lighter pink myometrium.

Cervical Stenosis and Metrorrhagia

The transvaginal ultrasound is from a 50 year old perimenopausal female with metrorhagia. The uterine cavity and cervical cavity are filled with fluid, and soft tissue elements are identified in the expanded cervical canal. The findings are consistent with cervical stenosis, burt the cause of the metrirhagia is not obvious. The stenosis was relieved and follow up ultrasound showed resolution. No cervical mass was identified.