The following symptoms and complaints may indicate hypermenorrhea: Leading symptom
- Hypermenorrhea – bleeding is excessive; usually the affected person consumes more than five pads/tampons per day; typically, there is discharge of coagulum (blood clots) with the menstrual blood
Warning signs (red flags)
- Menorrhagia – prolonged (> 6 days and increased menstruation or metrorrhagia (bleeding outside of menstruation) → think of: Endometrial cancer/uterine cancer (in about 20% of women, endometrial cancer occurs premenopausally (about ten to fifteen years before menopause) and about five percent of women are under 45 years of age).
- Dysmenorrhea (painful menstruation) + dyspareunia (pain during sexual intercourse) → think of: Endometriosis (occurrence of endometrium (lining of the uterus) outside the uterus, for example, in or on the ovaries (ovaries), tubes (fallopian tubes), urinary bladder, or intestines); adnexitis (ovarian inflammation), chronic
- Bleeding postcoital (after intercourse) → think of: Polyp (mucosal proliferation) of the cervix; ectopy (easily injured cylindrical epithelium on the cervical surface); cervical carcinoma (cervical cancer) [gynecological workup required!].