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Dr Marlena du Toit

Understanding the menstrual cycle PDF Print E-mail

Understanding the physiology of the normal menstrual cycle is imperative when evaluating a woman with abnormal uterine bleeding.

The normal menstrual cycle is characterized by

  • its length (mean 28 ± 7 days),
  • duration of flow (mean 4 ± 2 days)
  • amount of blood loss (mean 40 ± 20ml)

A diagram of the normal cycle:

Abnormal uterine bleeding is characterized by changes in either the frequency or duration of flow or the amount of blood loss. It is usually defined as dysfunctional uterine bleeding when pelvic pathology or underlying medical causes have been excluded; it commonly manifests itself in the absence of ovulation.
Management will be determined by the age of the woman suffering from abnormal uterine bleeding and her reproductive wishes.
Options include:
  • Medical management
    • Oral contraception
    • NSAIDS
    • Intra uterine device - Mirena®
  • Surgerical management
    • Hysteroscopy
    • Endometrial Ablation
    • Hysterectomy
If you have an abnormal menstruation cycle, you can help to determine the
diagnosis by keeping and electronic menstrual calendar.