Metrorrhagia: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate metrorrhagia:

Leading symptom

• Metrorrhagia – bleeding outside of menstruation proper; it is usually prolonged and increased, and a regular cycle is not apparent

Warning signs (red flags)

• Anamnestic information:
  • > 35 years of age → think of:
    • Cervical carcinoma/cervical cancer (two peaks of disease, with the early peak between ages 35 and 54 and the late peak after age 65).
    • 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)
  • Taking hormonal contraceptives or hormone replacement therapy → think of: Spotting (breakthrough bleeding).
• Purulent (purulent) cervical (“coming from the uterine canal”) fluorine/discharge (yellowish sticky fluor vaginalis/vaginal discharge) → think of: Cervicitis (cervical inflammation) due to chlamydial infection.
• Nausea, especially in the morning → think of: Gravidity (pregnancy)
• Lower abdominal pain, colicky, side-dependent (may be very mild initially!) → think of: Extrauterine pregnancy/pregnancy outside the uterus (usually occurs between the sixth and ninth week of pregnancy).