Menorrhagia. A symposium

This symposium reviewed current knowledge about the treatment of menorrhagia or excessive menstrual bleeding. In the absence of an organic cause medical treatment is preferred over surgical treatment especially if the patient desires future childbearing or will soon undergo natural menopause. Dilatation and curretage is the treatment of choice for women with meorrhagia and hypovolemia and for women over 35 years of age with acute bleeding. Drug treatment includes estrogens progestins clomiphene citrate antifibrinolytic agents danazol and nonsteroidal antiinflammatory agents. Acute bleeding can often be managed with 4 oral contraceptives/day containing 50 mcg of estrogen for several days. Nonsteroidal antiinflammatory agents particularly mefenamic acid in a dosage of 500 mg 3 times a day for 3 days markedly reduces excessive menstrual blood loss with few side effects. Physician panelist report a 10-15% incidence of menorrhagia among gynecologic patients. It is important to determine whether a patient is having cyclic ovulation since this affects the diagnosis and treatment.