Metrorrhagia can be defined as 'off schedule' bleeding. The bleeding, usually of normal or slight amount, occurs at either irregular or regular intervals outside of the normal menstrual flow. Metrorrhagia is one of many conditions sometimes caused by hormone irregularities, which can be labeled by the more general term, Dysfunction Uterine Bleeding – DUB.
A cycle of 22 to 35 days can be considered of normal length. Irregularity is any deviation of more than seven days from your normal pattern of bleeding. Occasional irregularity of menses
are very common and pregnancy is the most frequent cause of a late period. Irregular menstrual
bleeding occurs most often in adolescents and in women approaching menopause
breakthrough bleeding is caused by the production of estrogen without normal surges of luteinizing hormone
(LH) and secretion of progesterone
from the corpus luteum
. This may occur in high or low estrogen states and is the cause of most of the DUB
; it occurs at the extremes of the reproductive cycle. Midcycle spotting is caused by a decrease in estrogen at midcycle following ovulation. A luteal phase defect is associated with premenstrual spotting or polymenorrhea. A prolonged luteal phase is caused by extended corpus luteal activity and prolonged progesterone
production leading to prolonged cycles or long episodes of menstrual
Causes and Development
It can be caused by a hormonal imbalance (hyperthyroidism
); pregnancy disorder; cervical lesions
; medications (birth control pills, corticosteroids
, hypothalamic depressants, anticholinergics, anticoagulants); uterine fibroids
; functional ovarian cysts
of the vagina, cervix
, endometium or ovary
disease; coagulation disorders; anabolic steroid
use; IUDs or other trauma.
Diagnosis and TestsDysfunctional uterine bleeding
is a diagnosis of exclusion.