SlideShare una empresa de Scribd logo
1 de 45
Management of Menorrhagia (Heavy Menstrual Bleeding) Dr Tan Yiap Loong  Obstetric and Gynaecology Department Sarawak General Hospital
Definition ,[object Object],[object Object]
Definition ,[object Object],[object Object],[object Object]
How common is it? ,[object Object]
Normal Menstrual Cycle ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Previously…………. ,[object Object],[object Object],[object Object],[object Object]
Now…………. ,[object Object],[object Object],[object Object]
Risk Factors ,[object Object],[object Object],[object Object],[object Object]
Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is our goal? ,[object Object],[object Object]
How should I assess a woman with menorrhagia?
History and Physical Examination ,[object Object],[object Object],[object Object],[object Object]
History and Physical Examination ,[object Object],[object Object],[object Object],[object Object],[object Object]
History and Physical Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Investigations (Laboratory) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Investigations (Structural and Histological) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Investigations (Structural and Histological) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What advice and counselling should I give to a woman with menorrhagia?
Discuss……. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Give…….. ,[object Object],[object Object]
When should I prescribe pharmaceutical treatment in women presenting with menorrhagia?
Drug Treatment ,[object Object],[object Object],[object Object]
Drug Treatment ,[object Object],[object Object],[object Object],[object Object]
Drug Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Drug Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Drug Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Drug Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What should I do if initial drug treatment is ineffective in a woman with menorrhagia? ,[object Object],[object Object],[object Object]
How can I rapidly stop heavy bleeding, if necessary? ,[object Object]
Not Recommended ,[object Object],[object Object],[object Object]
When should I refer? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical Treatment ,[object Object],[object Object]
Non-hysterectomy or interventional radiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Non-hysterectomy or interventional radiology ,[object Object],[object Object]
Non-hysterectomy or interventional radiology ,[object Object],[object Object]
Hysterectomy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hysterectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Many Thanks
Referrences ,[object Object],[object Object]
 

Más contenido relacionado

La actualidad más candente

La actualidad más candente (20)

Disorders of menstruation
Disorders of menstruationDisorders of menstruation
Disorders of menstruation
 
Cervical erison
Cervical erisonCervical erison
Cervical erison
 
Uterine prolapse
Uterine prolapseUterine prolapse
Uterine prolapse
 
Menorrhagia
MenorrhagiaMenorrhagia
Menorrhagia
 
Uterine fibroids
Uterine fibroidsUterine fibroids
Uterine fibroids
 
Vaginal Fistula: Causes, Symptoms, Diagnosis, and Treatment
Vaginal Fistula: Causes, Symptoms, Diagnosis, and TreatmentVaginal Fistula: Causes, Symptoms, Diagnosis, and Treatment
Vaginal Fistula: Causes, Symptoms, Diagnosis, and Treatment
 
Uterine polyp
Uterine polypUterine polyp
Uterine polyp
 
Uterine fibroids
Uterine fibroidsUterine fibroids
Uterine fibroids
 
Menstrual irregularities
Menstrual irregularitiesMenstrual irregularities
Menstrual irregularities
 
Uterine polyps
Uterine  polypsUterine  polyps
Uterine polyps
 
Abnormal uterine bleeding
Abnormal uterine bleedingAbnormal uterine bleeding
Abnormal uterine bleeding
 
Endometriosis- Easy explanation with Management...
Endometriosis- Easy explanation with Management...Endometriosis- Easy explanation with Management...
Endometriosis- Easy explanation with Management...
 
Menopause
Menopause Menopause
Menopause
 
DUB (uterine bleeding)
DUB (uterine bleeding)DUB (uterine bleeding)
DUB (uterine bleeding)
 
Pelvic inflammatory disease ppt
Pelvic inflammatory disease pptPelvic inflammatory disease ppt
Pelvic inflammatory disease ppt
 
Congenital malformations of female genital tract ppt
Congenital  malformations of female genital tract pptCongenital  malformations of female genital tract ppt
Congenital malformations of female genital tract ppt
 
Menopause
MenopauseMenopause
Menopause
 
Amenorrhea
AmenorrheaAmenorrhea
Amenorrhea
 
Ectopic pregnancy
Ectopic pregnancyEctopic pregnancy
Ectopic pregnancy
 
dysfunctional uterine bleeding
dysfunctional uterine bleedingdysfunctional uterine bleeding
dysfunctional uterine bleeding
 

Destacado

Abnormal uterine bleeding
Abnormal uterine bleedingAbnormal uterine bleeding
Abnormal uterine bleedingraj kumar
 
Disfunctional uterine bleeding.gynaecology
Disfunctional uterine bleeding.gynaecologyDisfunctional uterine bleeding.gynaecology
Disfunctional uterine bleeding.gynaecologystudent
 
Abnormal Uterine Bleeding AUB
Abnormal Uterine Bleeding AUB Abnormal Uterine Bleeding AUB
Abnormal Uterine Bleeding AUB raheef
 
Dysfunctional uterine bleeding
Dysfunctional uterine bleedingDysfunctional uterine bleeding
Dysfunctional uterine bleedingNazni Nazar
 
Abnormal uterine bleeding
Abnormal uterine bleedingAbnormal uterine bleeding
Abnormal uterine bleedingdrmcbansal
 

Destacado (8)

Management of Menorrhagia
Management of MenorrhagiaManagement of Menorrhagia
Management of Menorrhagia
 
Abnormal uterine bleeding
Abnormal uterine bleedingAbnormal uterine bleeding
Abnormal uterine bleeding
 
Menorrhagia
MenorrhagiaMenorrhagia
Menorrhagia
 
Disfunctional uterine bleeding.gynaecology
Disfunctional uterine bleeding.gynaecologyDisfunctional uterine bleeding.gynaecology
Disfunctional uterine bleeding.gynaecology
 
Menorrhagia
MenorrhagiaMenorrhagia
Menorrhagia
 
Abnormal Uterine Bleeding AUB
Abnormal Uterine Bleeding AUB Abnormal Uterine Bleeding AUB
Abnormal Uterine Bleeding AUB
 
Dysfunctional uterine bleeding
Dysfunctional uterine bleedingDysfunctional uterine bleeding
Dysfunctional uterine bleeding
 
Abnormal uterine bleeding
Abnormal uterine bleedingAbnormal uterine bleeding
Abnormal uterine bleeding
 

Similar a Management of Menorrhagia

ABNORMAL UTERINE BLEEDING- WHAT IS NEW ?
ABNORMAL UTERINE BLEEDING- WHAT IS NEW ?ABNORMAL UTERINE BLEEDING- WHAT IS NEW ?
ABNORMAL UTERINE BLEEDING- WHAT IS NEW ?Dr. Sunita Chandra
 
16290 (10) benign and malignant disease of the breast
16290 (10) benign and malignant disease of the breast16290 (10) benign and malignant disease of the breast
16290 (10) benign and malignant disease of the breastBratasenaDanapati
 
Sangrado anormal
Sangrado anormalSangrado anormal
Sangrado anormalDr. Uresti
 
Disorders of the menstrual cycle 1
Disorders of the menstrual cycle 1Disorders of the menstrual cycle 1
Disorders of the menstrual cycle 1Magda Helmi
 
Menstrual disorders
Menstrual disordersMenstrual disorders
Menstrual disordersAmir Mahmoud
 
menstrual manipulation for adolescents with disability
 menstrual manipulation for adolescents with disability menstrual manipulation for adolescents with disability
menstrual manipulation for adolescents with disabilityMini Sood
 
URINARY TRACT INFECTIONS RISK FACTORS URINARY TRACT INFECTIONS RISK FACTORS
URINARY TRACT INFECTIONS RISK FACTORS 	 URINARY TRACT INFECTIONS RISK FACTORSURINARY TRACT INFECTIONS RISK FACTORS 	 URINARY TRACT INFECTIONS RISK FACTORS
URINARY TRACT INFECTIONS RISK FACTORS URINARY TRACT INFECTIONS RISK FACTORSMedicineAndHealth14
 
Mirena ppt for 2 july 14
Mirena ppt for 2 july 14Mirena ppt for 2 july 14
Mirena ppt for 2 july 14Lifecare Centre
 
Abnormal uterine bleeding
Abnormal uterine bleedingAbnormal uterine bleeding
Abnormal uterine bleedingMayur Pai
 
Management of endometrial hyperplasia
Management of endometrial hyperplasiaManagement of endometrial hyperplasia
Management of endometrial hyperplasiaEddie Lim
 
The future of percutaneous uterine fibroid embolization
The future of percutaneous uterine fibroid embolizationThe future of percutaneous uterine fibroid embolization
The future of percutaneous uterine fibroid embolizationHenry Wanga
 
Aub in adolescents edit2
Aub in adolescents edit2Aub in adolescents edit2
Aub in adolescents edit2ravikantraj55
 

Similar a Management of Menorrhagia (20)

Cgd 2
Cgd 2Cgd 2
Cgd 2
 
ABNORMAL UTERINE BLEEDING- WHAT IS NEW ?
ABNORMAL UTERINE BLEEDING- WHAT IS NEW ?ABNORMAL UTERINE BLEEDING- WHAT IS NEW ?
ABNORMAL UTERINE BLEEDING- WHAT IS NEW ?
 
16290 (10) benign and malignant disease of the breast
16290 (10) benign and malignant disease of the breast16290 (10) benign and malignant disease of the breast
16290 (10) benign and malignant disease of the breast
 
How to apprach case of abnormal vaginal bleeding
How to apprach case of abnormal vaginal bleedingHow to apprach case of abnormal vaginal bleeding
How to apprach case of abnormal vaginal bleeding
 
D0551821
D0551821D0551821
D0551821
 
Abnormal Uterine Bleeding.pptx
Abnormal Uterine Bleeding.pptxAbnormal Uterine Bleeding.pptx
Abnormal Uterine Bleeding.pptx
 
Sangrado anormal
Sangrado anormalSangrado anormal
Sangrado anormal
 
Disorders of the menstrual cycle 1
Disorders of the menstrual cycle 1Disorders of the menstrual cycle 1
Disorders of the menstrual cycle 1
 
01.Menopause.pptx
01.Menopause.pptx01.Menopause.pptx
01.Menopause.pptx
 
Menstrual disorders
Menstrual disordersMenstrual disorders
Menstrual disorders
 
20110522.dr.ho
20110522.dr.ho20110522.dr.ho
20110522.dr.ho
 
L42 Miscarriage & Ectopic
L42 Miscarriage & Ectopic L42 Miscarriage & Ectopic
L42 Miscarriage & Ectopic
 
menstrual manipulation for adolescents with disability
 menstrual manipulation for adolescents with disability menstrual manipulation for adolescents with disability
menstrual manipulation for adolescents with disability
 
URINARY TRACT INFECTIONS RISK FACTORS URINARY TRACT INFECTIONS RISK FACTORS
URINARY TRACT INFECTIONS RISK FACTORS 	 URINARY TRACT INFECTIONS RISK FACTORSURINARY TRACT INFECTIONS RISK FACTORS 	 URINARY TRACT INFECTIONS RISK FACTORS
URINARY TRACT INFECTIONS RISK FACTORS URINARY TRACT INFECTIONS RISK FACTORS
 
Mirena ppt for 2 july 14
Mirena ppt for 2 july 14Mirena ppt for 2 july 14
Mirena ppt for 2 july 14
 
Abnormal uterine bleeding
Abnormal uterine bleedingAbnormal uterine bleeding
Abnormal uterine bleeding
 
Gynecology 5th year, 4th lecture (Dr. Sindus)
Gynecology 5th year, 4th lecture (Dr. Sindus)Gynecology 5th year, 4th lecture (Dr. Sindus)
Gynecology 5th year, 4th lecture (Dr. Sindus)
 
Management of endometrial hyperplasia
Management of endometrial hyperplasiaManagement of endometrial hyperplasia
Management of endometrial hyperplasia
 
The future of percutaneous uterine fibroid embolization
The future of percutaneous uterine fibroid embolizationThe future of percutaneous uterine fibroid embolization
The future of percutaneous uterine fibroid embolization
 
Aub in adolescents edit2
Aub in adolescents edit2Aub in adolescents edit2
Aub in adolescents edit2
 

Más de limgengyan

Booklet for tagging ho 22.1.2015
Booklet for tagging ho 22.1.2015Booklet for tagging ho 22.1.2015
Booklet for tagging ho 22.1.2015limgengyan
 
Metformin paper in egj
Metformin paper in egjMetformin paper in egj
Metformin paper in egjlimgengyan
 
Prevention of Venous Thrombo-Embolism
Prevention of Venous Thrombo-EmbolismPrevention of Venous Thrombo-Embolism
Prevention of Venous Thrombo-Embolismlimgengyan
 
Prevention of pre-eclampsia
Prevention of pre-eclampsiaPrevention of pre-eclampsia
Prevention of pre-eclampsialimgengyan
 
Pelvic Inflammatory Disease
Pelvic Inflammatory DiseasePelvic Inflammatory Disease
Pelvic Inflammatory Diseaselimgengyan
 
Gynaecology cancer awareness
Gynaecology cancer awarenessGynaecology cancer awareness
Gynaecology cancer awarenesslimgengyan
 
Gynaecology cancer awareness
Gynaecology cancer awarenessGynaecology cancer awareness
Gynaecology cancer awarenesslimgengyan
 
Anemia in pregnancy
Anemia in pregnancyAnemia in pregnancy
Anemia in pregnancylimgengyan
 
MCDA Twin Pregnancy
MCDA Twin PregnancyMCDA Twin Pregnancy
MCDA Twin Pregnancylimgengyan
 
Pengendalian keganasan seksualiti
Pengendalian keganasan seksualitiPengendalian keganasan seksualiti
Pengendalian keganasan seksualitilimgengyan
 
Bad obstetric history
Bad obstetric historyBad obstetric history
Bad obstetric historylimgengyan
 
Cardiac diseases in pregnancy 30.7.2013
Cardiac diseases in pregnancy 30.7.2013Cardiac diseases in pregnancy 30.7.2013
Cardiac diseases in pregnancy 30.7.2013limgengyan
 
Vte risk assessment program presentation 2.ppt
Vte risk assessment program presentation 2.pptVte risk assessment program presentation 2.ppt
Vte risk assessment program presentation 2.pptlimgengyan
 
Sgh labour ward manual 2013
Sgh labour ward manual 2013Sgh labour ward manual 2013
Sgh labour ward manual 2013limgengyan
 
Anemia in pregnancy (updated oct 2012)
Anemia in pregnancy (updated oct 2012)Anemia in pregnancy (updated oct 2012)
Anemia in pregnancy (updated oct 2012)limgengyan
 
Anemia in pregnancy
Anemia in pregnancyAnemia in pregnancy
Anemia in pregnancylimgengyan
 
Preventing preterm labour
Preventing preterm labourPreventing preterm labour
Preventing preterm labourlimgengyan
 
Preventing preterm labour
Preventing preterm labourPreventing preterm labour
Preventing preterm labourlimgengyan
 
Severe pre eclampsia
Severe pre eclampsiaSevere pre eclampsia
Severe pre eclampsialimgengyan
 
Severe pre eclampsia
Severe pre eclampsiaSevere pre eclampsia
Severe pre eclampsialimgengyan
 

Más de limgengyan (20)

Booklet for tagging ho 22.1.2015
Booklet for tagging ho 22.1.2015Booklet for tagging ho 22.1.2015
Booklet for tagging ho 22.1.2015
 
Metformin paper in egj
Metformin paper in egjMetformin paper in egj
Metformin paper in egj
 
Prevention of Venous Thrombo-Embolism
Prevention of Venous Thrombo-EmbolismPrevention of Venous Thrombo-Embolism
Prevention of Venous Thrombo-Embolism
 
Prevention of pre-eclampsia
Prevention of pre-eclampsiaPrevention of pre-eclampsia
Prevention of pre-eclampsia
 
Pelvic Inflammatory Disease
Pelvic Inflammatory DiseasePelvic Inflammatory Disease
Pelvic Inflammatory Disease
 
Gynaecology cancer awareness
Gynaecology cancer awarenessGynaecology cancer awareness
Gynaecology cancer awareness
 
Gynaecology cancer awareness
Gynaecology cancer awarenessGynaecology cancer awareness
Gynaecology cancer awareness
 
Anemia in pregnancy
Anemia in pregnancyAnemia in pregnancy
Anemia in pregnancy
 
MCDA Twin Pregnancy
MCDA Twin PregnancyMCDA Twin Pregnancy
MCDA Twin Pregnancy
 
Pengendalian keganasan seksualiti
Pengendalian keganasan seksualitiPengendalian keganasan seksualiti
Pengendalian keganasan seksualiti
 
Bad obstetric history
Bad obstetric historyBad obstetric history
Bad obstetric history
 
Cardiac diseases in pregnancy 30.7.2013
Cardiac diseases in pregnancy 30.7.2013Cardiac diseases in pregnancy 30.7.2013
Cardiac diseases in pregnancy 30.7.2013
 
Vte risk assessment program presentation 2.ppt
Vte risk assessment program presentation 2.pptVte risk assessment program presentation 2.ppt
Vte risk assessment program presentation 2.ppt
 
Sgh labour ward manual 2013
Sgh labour ward manual 2013Sgh labour ward manual 2013
Sgh labour ward manual 2013
 
Anemia in pregnancy (updated oct 2012)
Anemia in pregnancy (updated oct 2012)Anemia in pregnancy (updated oct 2012)
Anemia in pregnancy (updated oct 2012)
 
Anemia in pregnancy
Anemia in pregnancyAnemia in pregnancy
Anemia in pregnancy
 
Preventing preterm labour
Preventing preterm labourPreventing preterm labour
Preventing preterm labour
 
Preventing preterm labour
Preventing preterm labourPreventing preterm labour
Preventing preterm labour
 
Severe pre eclampsia
Severe pre eclampsiaSevere pre eclampsia
Severe pre eclampsia
 
Severe pre eclampsia
Severe pre eclampsiaSevere pre eclampsia
Severe pre eclampsia
 

Último

Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...narwatsonia7
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋TANUJA PANDEY
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Dipal Arora
 
Call Girls Bareilly Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Dipal Arora
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadGenuine Call Girls
 
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...Arohi Goyal
 

Último (20)

Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 
Call Girls Bareilly Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
 
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 

Management of Menorrhagia

  • 1. Management of Menorrhagia (Heavy Menstrual Bleeding) Dr Tan Yiap Loong Obstetric and Gynaecology Department Sarawak General Hospital
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. How should I assess a woman with menorrhagia?
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. What advice and counselling should I give to a woman with menorrhagia?
  • 22.
  • 23.
  • 24. When should I prescribe pharmaceutical treatment in women presenting with menorrhagia?
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.  
  • 44.
  • 45.