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Metrorrhagia is an abnormality of the menstrual cycle in the reproductive female in which there is uterine bleeding occurring between menses (1).

It can be underlied by ovulation, endometrial polyps, fibroids, cervical infection, cervical polyps, cervical carcinoma, vaginal infection, vaginal carcinoma, endometrial hyperplasia, and endometrial carcinoma.

Metrorrhagia can be mid-cycle or late-cycle bleeding, which would slightly alter the course of treatment. For both, therapeutic options include:

  • Reassurance
  • Specific hormonal supplementation (i.e., mid-cycle estrogen)
  • Non-specific hormonal therapy (combined estrogen and progestin)