The Pathology of Abnormal Uterine Bleeding *

Abnormal uterine bleeding, the most common symptom of gynecological disease, is defined as menorrhagia or metrorrhagia. The former term applies only to an excessive loss of blood during the menstrual period. This loss may be evidenced in one of several ways: by an excessive menstrual flow, by a prolongation of the flow beyond the usual time limits, by a too frequent recurrence of the flow, or by the passage of blood clots. While in some patients the menorrhagia is functional in character, in others it indicates the presence of a definite local lesion. Metrorrhagia refers to uterine bleeding which is unrelated to menstruation or to ovulation. This symptom is uniformly interpreted as evidence of a local lesion, and is characteristic of malignant neoplasms. Until the pathology underlying menorrhagia and metrorrhagia is accurately diagnosed, correct methods of treatment are impossible. In the hope that it may prove useful to those in other fields of medicine, and particularly to students beginning their work in obstetrics and gynecology, this paper indicates the most important causes of abnormal uterine bleeding classified with reference to approximate age groups.