OBGYN: Patient with c/o Menorrhagia

Questions to ask from a patient who presents to the clinic with complains of Menorrhagia:

- Since when? (onset)

- How many pads does she use each day? (Assess flow)

- How soaked are they?

- Is there any soaking of clothes?

- Does she see any clots?

- How many days does she bleed?

- Is there any dysmenorrhea?

- Does she get weak? Feel dizzy?

- How do her heavy periods affect her daily life: Is she still able to continue with her house chores? Does she miss school or work because of her periods?

D/Ds of Menorrhagia:

1. Uterine fibroids (doctor might feel a mass in the abdomen on examination)
2. Endometriosis
3. Endometrial hyperplasia/ cancer
4. IUD contraceptive use
5. Hormone producing tumor of the ovary
6. PID (pelvic inflammatory disease)
7. Anticoagulant therapy (Ask about easy bruisiblity)
8. Vitamin K deficiency
9. Von Willebrand factor deficiency
10. Hormonal imbalance such as Cushing’s or Thyroid abnormalities (Ask the patient about recent weight gain? Weight loss? Heat and cold intolerance?)
11. Stress