[What kind of disease is it?] The normal amount of menstrual blood is usually 50 to 120 ml, but there is no clear definition of what amount is considered menorrhagia. In general, menorrhagia is defined as when blood clots (blood clots) are seen for more than two days or when anemia is present. There are two types of menorrhagia: functional menorrhagia that occurs when there is no particular abnormality in the uterus, and organic menorrhagia that occurs as a result of an abnormality in the uterus (column "Classification of menorrhagia by cause") [Treatment] For anovulatory cycles among functional menorrhagia, methods such as direct stimulation of the hypothalamus with clomiphene, Kaufmann therapy, and Holmstrom therapy (column "Hormone replacement therapy for treating amenorrhea") are used. For abnormal secretion of luteal hormone, Holmstrom therapy is used. In both cases, there are methods to control cyclical bleeding using pills (combination follicular and progesterone hormones) or to control menstrual flow by continuously taking small amounts of male hormones. In the case of organic menorrhagia, the first priority is to treat the underlying disease. However, in cases of benign diseases other than uterine cancer, instead of immediately undergoing surgery to remove the uterus, the degree of anemia is checked and blood-increasing drugs are administered to see if they can improve the condition. In cases where anemia worsens despite treatment with blood-increasing drugs, or where menorrhagia interferes with daily life, surgical treatment or pseudo-menopause treatment, in which menstruation is temporarily stopped and a state of menopause is created, are performed. As with functional menorrhagia, there are also treatments such as the use of oral contraceptives such as the pill to create a menstrual cycle and reduce menstrual flow, or the continuous use of small amounts of male hormones. The choice of treatment depends on your age. In addition to the above, if menorrhagia is caused by an internal illness, the underlying disease will be treated, and if it is caused by a contraceptive ring, it will be removed. Source: Shogakukan Home Medical Library Information |
[どんな病気か] 月経血(げっけいけつ)の量は、ふつう50~120mℓぐらいが正常とされますが、どの程度の量を過多月経というか、明確には決まっていません。一般に、血のかたまり(凝血(ぎょうけつ))が2日以上にわたってみられる場合や、貧血をともなうような場合、過多月経といいます。 過多月経には、子宮に特別な異常がないにもかかわらずおこる場合(機能性過多月経(きのうせいかたげっけい))と、子宮に異常があるためにおこる場合(器質性過多月経(きしつせいかたげっけい))とがあります(コラム「過多月経の原因別分類」)。 [治療] 機能性過多月経のうち、無排卵周期症(むはいらんしゅうきしょう)には、クロミフェンで視床下部(ししょうかぶ)を直接刺激する方法や、カウフマン療法・ホルムストローム療法(コラム「無月経治療のためのホルモン補充療法」)などが行なわれます。黄体(おうたい)ホルモンの分泌(ぶんぴつ)異常には、ホルムストローム療法が行なわれます。 また、どちらについても、ピル(卵胞(らんぽう)・黄体ホルモン合剤)を用いて周期性出血をコントロールしたり、少量の男性ホルモンを持続的に使用して月経量をコントロールする方法があります。 器質性過多月経の場合は、原因となっている病気の治療が第一です。しかし、子宮体がん以外の良性の病気では、すぐに手術して子宮を摘出するのではなく、貧血の程度をみて、増血剤を内服して改善するかどうかを調べます。 増血剤を用いての治療をしながらも貧血が進んでしまう場合や、過多月経によって生活に支障をきたしてしまう場合には、手術療法や、月経を一時止めて、閉経の状態をつくる偽閉経療法(ぎへいけいりょうほう)を行ないます。また、機能性過多月経と同様に、ピルのような経口避妊薬を用いて月経周期をつくり、月経量を減らす治療や、少量の男性ホルモンを持続的に使用する方法などもあります。 これらの治療法の選択は、年齢によって異なります。 以上のほか、内科的な病気による過多月経の場合は、原因となる病気の治療を行ない、避妊リングが原因の場合には取り除きます。 出典 小学館家庭医学館について 情報 |
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