Metrorrhagia: Definition, Causes, Symptoms, Diagnosis and Treatment

It is abnormal bleeding or spotting that usually occurs between periods or is not directly associated with regular menstruation.

Most women will probably refer to it simply as spotting.

Metrorrhagia, also known as dysfunctional uterine bleeding, is a common pathological condition in women of reproductive age.

Metrorrhagia is usually seen more frequently in the first years of menarche. The abnormal bleeding during this time is also known as pubertal bleeding.

Metrorrhagia is also seen in women who are close to menopause. In Metrorrhagia, uterine bleeding occurs in women outside their regular menstrual bleeding dates.

This is mainly stained, but severe bleeding can also occur in some cases.

The bleeding in Metrorrhagia is irregular in pattern, which means that abnormal bleeding can occur during a woman’s menstrual cycle. This may occur due to an underlying medical condition that must be investigated and treated more thoroughly.


Although there may be numerous medical conditions that can cause Metrorrhagia, it is usually not a severe condition. Once a cause is identified, successful treatment for Metrorrhagia can be performed. It is suggested to consult with an obstetrician/gynecologist immediately whenever a woman suspects an incidence of Metrorrhagia.

In contrast, normal vaginal bleeding occurs as part of a woman’s normal menstrual cycle that involves an intricate series of hormonal changes in the body, specifically changes in the levels of estrogen and progesterone.

The uterine lining accumulates extra blood and tissue in preparation for a possible fertilized egg and thickens every month. When the ovum is released from the ovary, the ovum is fertilized by the sperm and the implants in the uterus, or if fertilization does not occur, the lining of the uterus is detached.

As a result of detachment, periodic menstrual bleeding occurs. The average menstrual cycle is 28 days plus or minus seven days, usually lasting two to seven days. The cycle duration and amount of blood and fluid loss change with age.

What are the causes of Metrorrhagia?

As indicated above, there may be numerous causes leading to Metrorrhagia. Some of the causes of Metrorrhagia are:

Endometrial hyperplasia:  This condition arose due to abnormally high estrogen levels and decreased progesterone levels. This causes an irregularity and an imbalance in the body’s hormonal levels resulting in Metrorrhagia.

Uterine cancer:  This is one of the most common causes of Metrorrhagia.

Uterine cancer is mainly seen in older women who have reached their menopausal phase; therefore, postmenopausal women are more vulnerable to cancer of the uterus, resulting in Metrorrhagia. Ovarian cysts can also be one of the causes of Metrorrhagia.

Rupture of the polyp: This causes women who are unaware of having cervical or endometrial polyps not to seek a treatment that causes the rupture of these polyps and causes Metrorrhagia. Hemorrhage in such cases usually occurs after sexual intercourse.

Cervicitis:  This condition is caused as a result of cervical infection. As a result of this infection, the woman experiences Metrorrhagia. This condition requires immediate medical attention, as it can progress to a chronic condition, and the infection can also spread.

Miscarriage / Abortion:  A woman who has had a miscarriage or has had an abortion may also have Metrorrhagia. This may be due to particular fetal debris that causes such abnormal bleeding.

Infectious causes:  Metrorrhagia can also be caused due to unprotected sex resulting in sexually transmitted diseases.

Syphilis is a medical condition that is well known to cause Metrorrhagia. Women with a history of Lyme disease are also predisposed to frequent infections that can increase the incidence of Metrorrhagia.

Hormone imbalance: Hormone imbalances such as those caused by thyroid disorders can also lead to Metrorrhagia

Abnormal blood clotting:  Women who have a high affinity for bleeding and have coagulation problems are prone to have Metrorrhagia.

Contraception:  There are specific methods of barrier contraception that, when used, can cause a lesion in the vagina or lining of the uterus, which can cause Metrorrhagia. The intrauterine device or IUD is a standard contraceptive method that tends to cause Metrorrhagia.

Diagnosis of Metrorrhagia

Once the Doctor has this information, then she can perform a pelvic examination and can also inspect the vagina to look for infections or other abnormalities. This will help the Doctor identify any uterine problem.

Studies in the form of a transvaginal ultrasound may be performed to detect abnormalities within the uterus and cervix, such as a tumor that may cause the patient’s bleeding.

Finally, a Papanicolaou test will be performed to detect the presence of sexually transmitted diseases in the patient that may be causing the patient’s Metrorrhagia.

There are many possible causes of Metrorrhagia, including:

  • Hormonal imbalance such as anovulation.
  • Abnormal uterine growths such as polyps or fibroids.
  • Sexual intercourse with an injury to the cervix or vagina.
  • Complications of pregnancy.
  • Infection.
  • Uterine or vaginal cancer.
  • Endometriosis.
  • Ectopic pregnancy.
  • Miscarriage.
  • Deployment bleeding.

It is essential to contact your doctor if you experience Metrorrhagia.

There are various diagnostic approaches and treatments for Metrorrhagia, depending on the condition’s cause.

Symptoms of Menorrhagia

The main symptom of Metrorrhagia is mild or heavy bleeding or the appearance of spots between regular menstrual periods. You may or may not experience cramping or abdominal pain with bleeding.

A miscarriage or ectopic pregnancy can cause severe cramping with hemorrhage. If you have irregular bleeding, your doctor may examine you while you are bleeding. Do not delay an appointment because you are bleeding.

Recording your periods and irregular bleeding to bring to your appointment is helpful. Your doctor will review your medical history and symptoms. Your Doctor will perform a physical exam. Cultures can be taken during your pelvic exam to detect infections or sexually transmitted diseases.

Blood tests may be used to evaluate your thyroid and hormone levels. You may have a pregnancy test. You can take a Pap test to check for cervical cancer.

An ultrasound may create images of your reproductive organs, allowing your doctor to check for abnormal growth. For an ultrasound, your doctor will place a driving device in your lower abdomen or gently place a driving rod into your vagina.

The driving device transmits sound waves to a computer that creates images on a video monitor. An endometrial biopsy may be used to obtain cells from your uterus to detect imbalances or hormonal abnormalities.

Some types of biopsy methods can be done in your Doctor’s office or as an outpatient with general anesthesia.


Treatment of Metrorrhagia begins as soon as a cause of the disease is identified. Suppose the cause is more benign, such as an infection or a sexually transmitted disease. In that case, medications can be given to the patient to cure the condition and get relief from the Metrorrhagia.

The patient will be asked to rest entirely in bed until the causative factor is treated since excessive blood loss can cause the patient to become anemic, which can have inherent complications.

In some cases where the patient has a severe hemorrhage, the patient can be transferred to a hospital for observation and treatment until the condition has been completely treated.

In cases where abortion or abortion is the cause of Metrorrhagia, a procedure called Dilation and curettage or D and C will be performed to clean the uterus and cervix of any remnant of the fetus that may be causing Metrorrhagia.

The patient can also receive oral contraceptives instead of devices to regulate hormone levels and restrict the incidence of Metrorrhagia.

Medications containing estrogen can be given for other hormonal abnormalities to restore estrogen levels, correct a woman’s menstrual cycle, and treat Metrorrhagia.

More studies will be performed in case of suspicion of cancer as a cause of Metrorrhagia, including a biopsy to verify the cancer stage. Additional treatment will be given, including radiation and chemotherapy.

In all cases, the patient must receive iron pills, as it is pretty standard for the patient to have deficient iron levels due to excessive blood loss due to Metrorrhagia.

For more information about this pathology, consult Doctor.