Pathogenesis (development of disease)
Hypermenorrhea is said to occur when the patient needs more than 5 tampons/pads per day.
Hypermenorrhea is one of the type abnormalities in the menstrual cycle. It is often caused by endometriosis (presence of endometrium (lining of the uterus) outside its physiological location) or fibroids (benign growths of the uterine muscles), but it can also be caused by coagulation disorders or other changes in the uterus (womb).
Etiology (causes)
Biographic causes
- Hormonal factors
- Puberty
- Perimenopause – transitional phase between premenopause and postmenopause; varying lengths of years before menopause (about five years) and after menopause (1 year).
Causes related to disease
Blood, blood-forming organs – immune system (D50-D90).
- Coagulation disorders
Endocrine, nutritional and metabolic disorders (E00-E90).
- Hypothyroidism (underactive thyroid gland).
- Premenstrual progestin deficit – deficiency of luteal hormone before the onset of menstruation.
Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).
- Cirrhosis of the liver (liver shrinkage).
Neoplasms – tumor diseases (C00-D48)
Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).
- Adnexitis (ovarian inflammation), chronic.
- Adenomyosis (adenomyosis uteri) – pathological change in the lining of the uterus (endometrium), whereby it proliferates into the underlying muscles (myometrium).
- Endometritis (inflammation of the uterus); including tuberculous endometritis.
- Endometriosis – disease in which the endometrium grows outside the uterus such as in the ovary (ovary) or the vesica urinaria (urinary bladder).
- Glandular-cystic hyperplasia of the endometrium – pathological thickening of the endometrium due to increased estrogen action (eg, follicular persistence).
- Polyps (mucosal growths) of the cervix (cervix) or endometrium (endometrium).
- Uterine hyperplasia – proliferation of the endometrium.
- Uterine fibroids – benign tumors in the uterus.
Medication
- Hormonal contraceptives (birth control pills), hormone replacement therapy.
- Intrauterine device (“IUD”).
Other causes
- Follicular maturation disorders (oocyte maturation disorders) with consequent follicular persistence (failure to ovulate), endometrial hyperplasia (increase in volume (hyperplasia) of the endometrium) and breakthrough bleeding (esp. adolescence or perimenopause).