Metrorrhagia: Overview

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.

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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.

Anovulatory or estrogen 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 bleeding.

Causes and Development

It can be caused by a hormonal imbalance (hyperthyroidism or hypothyroidism); pregnancy disorder; cervical lesions; medications (birth control pills, corticosteroids, hypothalamic depressants, anticholinergics, anticoagulants); uterine fibroids; functional ovarian cysts; polyps; carcinoma of the vagina, cervix, endometrium or ovary; renal or liver disease; coagulation disorders; anabolic steroid use; IUDs or other trauma.

Diagnosis and Tests

Dysfunctional uterine bleeding is a diagnosis of exclusion.

Signs, symptoms & indicators of Metrorrhagia:

Symptoms - Reproductive - Female Cycle

Conditions that suggest Metrorrhagia:


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Risk factors for Metrorrhagia:




Prolonged and/or heavy periods are a sign of hypothyroidism.


Tumors, Benign

Ovarian Cysts

Ovarian cysts may cause a variety of menstrual abnormalities, including Metrorrhagia, depending on the hormone produced by the cyst.  Metrorrhagia can also be a result of an ovarian cyst being unusually large, blocking the blood supply or rupturing.

Tumors, Malignant

Endometrial Cancer

The most common sign of endometrial cancer is unusual bleeding from the vagina, especially bleeding that occurs after passing through menopause.

Metrorrhagia suggests the following may be present:


Recommendations for Metrorrhagia:

Botanical / Herbal

Vitex / Chasteberry

Vitex acts on the pituitary gland in the brain to adjust levels of LH (luteinizing hormone) and FSH (follicle stimulating hormone).  Vitex indirectly promotes progesterone in cases of excess estrogen.  Overall, it helps to restore normal rhythm to the reproductive hormones.


Stoneseed (Lithosperma ruderale) and gromwell (L. officinale) have a progesterone-like effect that helps balance excess estrogen.  Both species of lithosperma may act directly on the hypothalamus to improve hormonal regulation and promote a regular cycle.

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