What is metrorrhagia, and what causes it?
Metrorrhagia refers to any abnormal uterine bleeding that occurs outside of the menstrual cycle—between periods, after menopause, or after sexual intercourse. It is a gynecological symptom that always requires a medical evaluation to identify the underlying cause. Some types of bleeding may indicate a serious condition. An immediate gynecological consultation is essential. Nutritional supplements for cases of associated anemia are available in the store’s iron and blood vitality line.
- Hormonal and functional causes: estrogen/progesterone imbalance (anovulatory cycles)—hypothyroidism or hyperthyroidism—polycystic ovary syndrome (PCOS)—hormonal contraceptives (birth control pill, hormonal IUD, implant — adjustment bleeding) — perimenopause (frequent hormonal fluctuations)
- Structural causes: uterine fibroids (leiomyomas) — endometrial or cervical polyps — adenomyosis (endometrium invading the myometrium) — copper intrauterine device (IUD)
- Pathological causes to rule out as a priority: endometrial cancer (the primary diagnosis to rule out after menopause) — cervical cancer — atypical endometrial hyperplasia — ectopic pregnancy (medical emergency)
- Systemic causes: coagulation disorders (von Willebrand disease, thrombocytopenia) — liver failure — anticoagulant or antiplatelet medications
How is it diagnosed, and when should you seek emergency care?
- See a gynecologist immediately if: any bleeding between periods — postcoital bleeding — bleeding after menopause (any postmenopausal bleeding = a gynecological emergency until proven otherwise) — worsening menorrhagia (heavy or prolonged periods) — signs of anemia (pallor, fatigue, shortness of breath)
- Call 15 immediately if: heavy bleeding (> 1 pad per hour) — severe pelvic pain plus a missed period (ectopic pregnancy) — bleeding accompanied by hemodynamic instability (hypotension, tachycardia, syncope)
- Diagnostic workup: gynecological examination — cervical and vaginal smear — pelvic ultrasound (suprapubic and transvaginal) — hormone levels (FSH, LH, estradiol, progesterone, TSH, beta-hCG) — Complete blood count (CBC) + coagulation panel — diagnostic hysteroscopy (direct visualization of the uterine cavity) — endometrial biopsy if postmenopausal
- Medical and surgical treatments: hormone therapy (contraceptives, progestins) — hysteroscopic resection (polyps, submucosal fibroids) — endometrectomy — hysterectomy if necessary — strictly by medical and gynecological prescription — never use as a substitute for prescribed treatment
Nutritional support for metrorrhagia and associated anemia
These nutritional approaches support comfort as part of gynecological care—they do not treat the cause of menorrhagia and are not a substitute for prescribed medical treatment. Consult with your doctor or gynecologist before taking any supplements.
- Iron: Repeated metrorrhagia leads to iron depletion → iron-deficiency anemia —supplementation based on test results (ferritin, complete blood count) under medical supervision— iron supplements available at pharmacies —combine with vitamin C to improve the absorption of non-heme iron
- Chasteberry (Vitex agnus-castus): modulates prolactin and LH/FSH ratios — supports hormonal balance in irregular cycles associated with luteal insufficiency — well-established traditional use — Contraindicated during pregnancy and breastfeeding — Interacts with contraceptives and dopaminergic treatments — Medical consultation required
- Vitamin K: cofactor in blood clotting — green vegetables (spinach, broccoli, lamb’s lettuce) — extreme caution required in patients taking anticoagulants
