Abnormal uterine bleeding

Jump to: navigation, search


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Nima Nasiri, M.D.[2]Farman Khan, MD, MRCP [3]

Causes

Common Causes


Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Blood thinners, breakthrough bleeding in women using hormonal birth control, copper intrauterine device , depo-Provera

hormone replacement therapy, tamoxifen, corticosteroids, chemotherapy, clomiphene, dilantin, antipsychotic drugs , antibiotics ( due to toxic epidermal necrolysis or Stevens-Johnson syndrome )

Ear Nose Throat No underlying causes
Endocrine Diabetes, hyperthyroidism, hypothyroidism, Cushing's syndrome, Hormone secreting adrenal and ovarian tumors
Environmental No underlying causes
Gastroenterologic Liver disease
Genetic No underlying causes
Hematologic Clotting disorders, Von Willebrand disease, thrombocytopenia or platelet dysfunction,

acute leukemia ,Some factor deficiencies, Advanced liver disease

Iatrogenic Radiation therapy
Infectious Disease Chlamydia, gonorrhea, uterine infection, genitourinary tract infection, bacterial vaginosis

sexually transmitted diseases, atrophic vaginitis

Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic Adenomyosis, atrophy of the tissue lining the vagina and uterus, cervicitis, ectopic pregnancy, endometrial hyperplasia, endometritis, uterine sarcoma, first few months after the first menstrual period, first few weeks after abortion, first few weeks after delivery, intrauterine device, miscarriage, ovarian cysts, placenta previa, polycystic ovarian syndrome, retained products of conception, uterine fibroids, uterine polyps, diseases involving the vulva for example Crohn's disease, Behcet's syndrome , pemphigoid , pemphigus , erosive lichen planus , lymphoma, skin tags, sebaceous cysts, condylomata, angiokerataoma
Oncologic Cancer or precancer of the cervix , cancer or precancer of the endometrium, ovarian cancer, uterine cancer, uterine sarcoma
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte Chronic renal disease
Rheum / Immune / Allergy No underlying causes
Sexual Sexual abuse
Trauma Sexual intercourse , sexual abuse , foreign bodies (including IUD) , pelvic trauma, Straddle injuries
Urologic Genitourinary tract infection
Dental No underlying causes
Miscellaneous Foreign body, irritation of the genital area due to bubble baths, soaps, lotions or infection, smoking,

Excessive exercise

Causes in Alphabetical Order


Treatment

Contraindicated medications


Template:Abnormal uterine bleeding Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4] Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[5]

Overview

Abnormal uterine bleeding is defined as any alteration in the amount of menstrual blood flow or duration of menstruation. Women can experience heavy menstrual bleeding or irregular menstrual bleeding or combination of both. Normal menstruation occurs every 21 to 35 days and lasts 3 to 7 days.The diagnosis and evaluation of abnormal uterine bleeding is based on patient's assessment of her blood loss and its impact on her health status. There are structural and non-structural causes of abnormal uterine bleeding. Causes of abnormal uterine bleeding can be cervical cancer, cervical leiomyoma, polyps, coagulation disorders.

Abnormal uterine bleeding differential diagnosis

  • Abnormal uterine bleeding differential diagnosis include:[1][2]
  • Endometrial hyperplasia
  • Cervical polyp
  • Cervical leiomyoma
  • Cervical lymphoma
  • Cervical sarcoma
  • Metastases to the cervix
  • Cervical ectopic pregnancy
  • Cervicitis
  • Cervical erosion ( Ectropion )
  • IUD use
  • Pelvic inflammatory disease
  • Endometriosis
  • Adenomyosis
  • Postcoital bleeding
  • Clear cell adenocarcinoma
  • Hematologic causes:
    • Von willebrand disease
    • Thrombocytopenia
    • Clotting disorder
    • Platelet dysfunction
    • Factors deficiency
Abnormal Uterine bleeidng differential diagnosis
Ob-Gyn neoplasm and diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical exam Lab Findings Imaging Histopathology
Abnormal

vaginal bleeding

Other GU/GI symptoms Abdominal pain Pelvic

pain

Constitutional symptoms Gynecological examinations Abdominal

mass

HPV

Pap smear

STI panel

Other labs Ultrasound Other

imagings

Cervical cancer[3][4][5][6][7][8][9][10]

+

+ +
  • Cervical mass on exam
+ ± HPV T2-weighted MRI :
  • Ovoid, heterogeneous tumor distending the cervical canal with stromal involvement. PET/CT scan:
Cervical intraepithelial neoplasia:
Cervical polyp[11]
  • Mass on exam
  • RBC count
  • ↓ Hb, ↓ Hct
  • ↓ Serum Iron
  • Hyper/hypoechogenic masses with or without cysts
  • Filling the endocervical or vaginal canal
Cervical leiomyoma[12][13][14][15][16][17][18][19][20]
  • Heavy/prolonged menstrual bleeding
  • Intermenstrual bleeding
+ + ±
  • Well circumscribed hyperechoic mass
T2-weighted MRI:
  • Hypointense masses
  • Homogeneous

enhancement

  • Red degeneration
  • Clinical diagnosis/ and
Cervical lymphoma[21][22][23]
  • Difficulty urinating
  • Post-coital pain
+ + +
  • Irregularity
+ Pap smear:
  • Small round blue cells
  • High nuclear/cytoplasm ratio,
  • Scant cytoplasm
Immunohistochemistry markers:
  • Well-defined, solid, concentric, hypoechoic mass
MRI:
  • Intramyometrial infiltrative nodules
Cervical sarcoma[24][25][26][27] + + ± + Leiomyosarcoma markers: MRI:
  • Endometrial polypoid mass
  • Hypointense hypervascular solid components
Cervical erosion(Ectropion)[28][29][30][31][32]
  • Light bleeding after pelvic exam
  • Spotting
  • Post-coital pain
  • Painful cramps
+ + N/A N/A N/A
Cervicitis[33][34][35][36][37]
  • Intermenstrual bleeding
  • Postcoital
  • Bleeding after pelvic exam
  • Pain during urination
+ +
  • May have fever only
  • Red,inflammed swollen cervix
  • Inflammation/irritation of vulva/vagina
STI panel:
MRI:

May be detected as retention cysts in cervix.

Endometrial carcinoma[38][39][40][41][42]

bleeding

  • Pain during sex
  • Fulness in pelvic
  • Difficulty emptying bladder
+ + ±
  • Often normal
+
  • Myometrial invasion

T1-weighted MRI:

  • Hypo-to-isointense

T2-weighted MRI:

  • Intermediate signal intensity lower than the normal endometrium
Type I endometrioid endometrial carcinomas (EECs):
  • Moderately differentiated
  • Superficial invasion into the myometrium

Type II non-endometrioid endometrial carcinomas (NEECs):

Endometrial hyperplasia[43][44][45]
  • +
+
  • Normal or thickened endometrium
± N/A

T1-weighted MRI:

  • Hypo-to-isointense
  • Complex hyperplasia
  • Simple hyperplasia with atypia
Endometriosis[46][47][48][49][50][51][52]
  • Heavy mentrual bleeding
+ +

(limited value)

  • Ground glass echogenicity of the cyst fluid (Endometrioma)
  • Cysts are unilocular
Pelvic inflammatory diseases[53][54][55][56]
  • Bleeding after sex
  • Intermenstrual bleeding
  • Pelvic pain
+
  • Oral temperature >101F
  • Vaginal/vulvar tender lesion depending on microbial causes
STI panel:
  • WBC
  • Oral temperature >101F
Ultrasound:
  • Thickened, fluid-filled tubes with or without free pelvic or tubo-ovarian complex
MRI findings:
  • Inflammation in pelvic soft tissue
  • Clinical diagnosis is gold standard for diagnosing PID
Adenemyosis[57][58][59][60][61][62]
  • Abnormal uterine bleeding
  • Painful menstruation
+ +
  • Polypoid mass protruding into the endocervical canal.
  • Subendometrial striations
  • Myometrial cysts
  • Asymetrical thickness in myometrium walls
  • Heterogenous echotexture of myometrum
MRI:
  • Thickened junctional zone
  • Presence of ectopic endometrial glands into the myometrium.
Cervical ectopic pregnancy[63][64] +
  • Soft and disporportionally enlarged uterus.
± T2-weighted MRI:
  • Hypointense large mass

T1-weighted MRI:

  • Partially hyperintense mass
Vaginal cancer[65][66][67][68]
  • Postcoital bleeding
+ + ±
  • Ill-defined vaginal ulcer
Ultrasound: MRI:
  • Isointense on T1-weighted images
  • Soft-tissue mass with intermediate-to-high signal intensity on T2-weighted images
Biopsy findings:
Paget's disease of vulva to cervix[69][70][71][72][73]
  • Bleeding/oozing from lesion
  • Pain in vulva
  • Itching or burning sensation in vulva
  • Negative for S-100 and Melan-A
N/A MRI:
  • Hyperintense on diffusion weighted imaging
  • Thick vulvar skin
  • "Cake-icing effect", pathognomic for vulvar paget's disease
Nabothian cyst[74][75][76][77]
  • Postcoital bleeding
  • Majority of them are asymptomatic due to their small size (few milimeters)
N/A
  • Anechoic well defined cystic lesions
T1-weighted
  • Intermediate or slightly high signal intensity T2-weighted
  • High signal intensity on T2-weighted images
  • Benign cystic lesion
  • Multiple benign cystic masses, usually few milimieters in diameter.
IUD use[78][79][80]
  • Heavy bleeidng
+ +
  • Normal
  • May have decreased RBC count
  • Linear echogenic intrauterine structures
N/A N/A


Pregnancy and pregnancy related conditions Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Abnormal uterine bleeding Other symptoms
Miscarriage[81][82] +
  • Enlarged uterus
  • Blood clot in cervical os.
Ultrasound:
Abruptio placenta[83][84] +
  • Uterine tenderness
  • ↓ Fetal heart rate
  • ↓ Fetal movement

Ultrasound:

  • Uterine hypertonicity
  • Non-reassuring fetal heart
Placenta previa[85][86][87] +
  • Usually painless vaginal bleeding
  • Uterine contraction
  • Blood clot or spotting
Ultrasound:
  • Low lying placenta, less than 1cm from cervical os.
Ectopic pregnancy[88][89] + Ultrasound:
  • Absence of "Sliding sign" on gentle pressure of cervix
  • Tubal rupture
Associated conditions:
Molar pregnancy[90][91][92] +
  • Heavy vaginal bleeding
Ultrasound:
  • Complex and echogenic intrauterine mass
  • Containing many small cystic spaces
  • Classical "snow storm" appearance
  • Hydropic villi
  • Histological confirmation post-curettage
Associated conditions:
Hematologic conditions Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab findings Imaging Histopathology
Abnormal uterine

bleeding

Other symptoms
Von willebrand disease[93][94][95] +
  • Easy bruising
  • Gum/dental bleeding
  • Heavy menses
N/A N/A
  • Most common inherited bleeding disorder
  • History of bleeding disorder in family members.
Factors deficiencies[96][97] +
  • Easy bruising
  • Gum/dental bleeding
  • Heavy menses
  • Fatigue
  • Blood in stool
  • Blood in urine
N/A N/A
  • History of bleeding disorder in family members.
Platelet dysfunction[98][99][100][101][102] ± N/A N/A Gold standard diagnostic test:
  • Light transmission aggregometry (LTA)

Other useful diagnostic tests:

Associated conditions:
Metabolic conditions Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab findings Imaging Histopathology
Abnormal uterine bleeding Other symptoms
Hyperthyroidism[103][104] +
  • Wet skin/hair thinning
  • Low TSH
  • TSH receptor antibodies (TRAb)
Ultrasound:
  • Homogenous hypo-echogenicity
Microscopic histology:
  • Lymphocytic infiltration in follicles
  • Enlarged colloids

For Grave's disease:

  • TSH receptor antibody
Associated conditions:
Hypothyroidism[105][106][107][108][109] +
  • Dry skin
  • Hair loss
Ultrasound:
  • Homogenous hypo-echogenicity
Microscopic histology: Associated conditions with Hashimoto thyroiditis:
Adrenal hyperplasia[110][111][112][113][114] +
  • Irregular menses
Depending upon deficient enzyme:

Depending upon enzyme deficiencies may include the following:

CT-Scan:
  • Enlargement of glands
  • Cosyntropin stimulation test (250 μg cosyntropin intravenously):
Cushing's disease[115][116] +
  • Facial plethora
  • Abnormal fat distribution
  • Violacious striae
  • Emotional lability
T1-weighted MRI: Associated conditions:
Polycystic ovarian syndrome[117][118][119][120][121] + Ultrasound:
  • ↑ Number of follicles
  • ↑ Ovarian volume
  • Fluid filled ovaries
  • Multiple cysts in ovaries bilaterally.
Associated conditions:
  • Insulin resistance
Medication side effects/ Iatrogenic Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Abnormal uterine bleeding Other symptoms
Anticoagulants[122][123][124]
  • +
  • Heavy menstrual bleeding
  • Pallor
  • Heavy menstrual bleeding
N/A N/A
  • Complete medication history
Antipsychotics[125] +
  • Sexual dysfunction
N/A N/A
  • Complete medication history
  • Serum prolactin test
  • History of mood disorders
Oral contraceptive pills[126]
  • Break through bleeding
  • Heavy bleeding
N/A N/A
  • Ruling out organic cause, complete history of medication use
Herbal supplements[127][128][129] +
  • Heavy menstrual bleeding
  • Menstrual irregularity
Ultrasound:
  • Complete medication history

References

  1. Munro, Malcolm G.; Critchley, Hilary O.D.; Broder, Michael S.; Fraser, Ian S. (2011). "FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age". International Journal of Gynecology & Obstetrics. 113 (1): 3–13. doi:10.1016/j.ijgo.2010.11.011. ISSN 0020-7292.
  2. Matteson, Kristen A.; Boardman, Lori A.; Munro, Malcolm G.; Clark, Melissa A. (2009). "Abnormal uterine bleeding: a review of patient-based outcome measures". Fertility and Sterility. 92 (1): 205–216. doi:10.1016/j.fertnstert.2008.04.023. ISSN 0015-0282.
  3. Hippisley-Cox J, Coupland C (January 2013). "Symptoms and risk factors to identify women with suspected cancer in primary care: derivation and validation of an algorithm". Br J Gen Pract. 63 (606): e11–21. doi:10.3399/bjgp13X660733. PMC 3529288. PMID 23336450.
  4. Dunyo, Priscilla; Effah, Kofi; Udofia, Emilia Asuquo (2018). "Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study". BMC Public Health. 18 (1). doi:10.1186/s12889-018-6065-6. ISSN 1471-2458.
  5. Khalife D, El Housheimi A, Khalil A, Saba C S, Seoud M, Rammal R, Abdallah IE, Abdallah R (February 2019). "Treatment of cervical cancer metastatic to the abdominal wall with reconstruction using a composite myocutaneous flap: A case report". Gynecol Oncol Rep. 27: 38–41. doi:10.1016/j.gore.2018.12.006. PMC 6302027. PMID 30603660. Vancouver style error: name (help)
  6. . doi:10.1097/PAS.0000000000000498. Check |doi= value (help). Missing or empty |title= (help)
  7. Brenner PF (September 1996). "Differential diagnosis of abnormal uterine bleeding". Am. J. Obstet. Gynecol. 175 (3 Pt 2): 766–9. PMID 8828559.
  8. Alcázar, Juan Luis; Arribas, Sara; Mínguez, José Angel; Jurado, Matías (2014). "The Role of Ultrasound in the Assessment of Uterine Cervical Cancer". The Journal of Obstetrics and Gynecology of India. 64 (5): 311–316. doi:10.1007/s13224-014-0622-4. ISSN 0971-9202.
  9. Qing L, Xiang T, Guofu Z, Weiwei F (September 2014). "Leukemoid reaction in cervical cancer: a case report and review of the literature". BMC Cancer. 14: 670. doi:10.1186/1471-2407-14-670. PMC 4174654. PMID 25223869.
  10. Qing L, Xiang T, Guofu Z, Weiwei F (September 2014). "Leukemoid reaction in cervical cancer: a case report and review of the literature". BMC Cancer. 14: 670. doi:10.1186/1471-2407-14-670. PMC 4174654. PMID 25223869.
  11. Mitchell H (May 2004). "Vaginal discharge--causes, diagnosis, and treatment". BMJ. 328 (7451): 1306–8. doi:10.1136/bmj.328.7451.1306. PMC 420177. PMID 15166070.
  12. Al-Habib A, Elgamal EA, Aldhahri S, Alokaili R, AlShamrani R, Abobotain A, AlRaddadi K, Alkhalidi H (November 2016). "Large primary leiomyoma causing progressive cervical deformity". J Surg Case Rep. 2016 (11). doi:10.1093/jscr/rjw190. PMC 5159177. PMID 27887011.
  13. Adaikkalam J (April 2016). "Lipoleiomyoma of Cervix". J Clin Diagn Res. 10 (4): EJ01–2. doi:10.7860/JCDR/2016/16505.7531. PMID 27190823.
  14. Houser, L. Murray; Carrasco, C. H.; Sheehan, C. R. (1979). "Lipomatous tumour of the uterus: radiographic and ultrasonic appearance". The British Journal of Radiology. 52 (624): 992–993. doi:10.1259/0007-1285-52-624-992. ISSN 0007-1285.
  15. Keriakos, Remon; Maher, Mark (2013). "Management of Cervical Fibroid during the Reproductive Period". Case Reports in Obstetrics and Gynecology. 2013: 1–3. doi:10.1155/2013/984030. ISSN 2090-6684.
  16. Coronado GD, Marshall LM, Schwartz SM (May 2000). "Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study". Obstet Gynecol. 95 (5): 764–9. PMID 10775744.
  17. Kamra, Hemlata T (2013). "Myxoid Leiomyoma of Cervix". JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. doi:10.7860/JCDR/2013/6171.3805. ISSN 2249-782X.
  18. El-agwany, Ahmed Samy (2015). "Lipoleiomyoma of the uterine cervix: An unusual variant of uterine leiomyoma". The Egyptian Journal of Radiology and Nuclear Medicine. 46 (1): 211–213. doi:10.1016/j.ejrnm.2014.10.001. ISSN 0378-603X.
  19. Chaparala RP, Fawole AS, Ambrose NS, Chapman AH (March 2004). "Large bowel obstruction due to a benign uterine leiomyoma". Gut. 53 (3): 386, 430. PMC 1773948. PMID 14960521.
  20. Yokoyama Y, Shinohara A, Hirokawa M, Maeda N (2003). "Erythrocytosis due to an erythropoietin-producing large uterine leiomyoma". Gynecol. Obstet. Invest. 56 (4): 179–83. doi:10.1159/000074104. PMID 14564105.
  21. Grace A, O'Connell N, Byrne P, Prendiville W, O'Donnell R, Royston D, Walsh CB, Leader M, Kay E (1999). "Malignant lymphoma of the cervix. An unusual presentation and a rare disease". Eur. J. Gynaecol. Oncol. 20 (1): 26–8. PMID 10422676.
  22. Kanaan, Daniel; Parente, Daniella Braz; Constantino, Carolina Pesce Lamas; Souza, Rodrigo Canellas de (2012). "Linfoma de colo de útero: achados na ressonância magnética". Radiologia Brasileira. 45 (3): 167–169. doi:10.1590/S0100-39842012000300009. ISSN 0100-3984.
  23. Frey NV, Svoboda J, Andreadis C, Tsai DE, Schuster SJ, Elstrom R, Rubin SC, Nasta SD (September 2006). "Primary lymphomas of the cervix and uterus: the University of Pennsylvania's experience and a review of the literature". Leuk. Lymphoma. 47 (9): 1894–901. doi:10.1080/10428190600687653. PMID 17065003.
  24. Wright JD, Rosenblum K, Huettner PC, Mutch DG, Rader JS, Powell MA, Gibb RK (November 2005). "Cervical sarcomas: an analysis of incidence and outcome". Gynecol. Oncol. 99 (2): 348–51. doi:10.1016/j.ygyno.2005.06.021. PMID 16051326.
  25. Khosla, Divya; Gupta, Ruchi; Srinivasan, Radhika; Patel, Firuza D.; Rajwanshi, Arvind (2012). "Sarcomas of Uterine Cervix". International Journal of Gynecological Cancer. 22 (6): 1026–1030. doi:10.1097/IGC.0b013e31825a97f6. ISSN 1048-891X.
  26. Miccò M, Sala E, Lakhman Y, Hricak H, Vargas HA (December 2015). "Imaging Features of Uncommon Gynecologic Cancers". AJR Am J Roentgenol. 205 (6): 1346–59. doi:10.2214/AJR.14.12695. PMC 5502476. PMID 26587944.
  27. . doi:10.1097/IGC.0b013e31825a97f6. Check |doi= value (help). Missing or empty |title= (help)
  28. Mitchell L, King M, Brillhart H, Goldstein A (September 2017). "Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis". Sex Med. 5 (3): e212–e214. doi:10.1016/j.esxm.2017.03.001. PMC 5562466. PMID 28460993.
  29. Mitchell H (May 2004). "Vaginal discharge--causes, diagnosis, and treatment". BMJ. 328 (7451): 1306–8. doi:10.1136/bmj.328.7451.1306. PMC 420177. PMID 15166070.
  30. Sharma, Abhishek; Ojha, Ranapratap; Sengupta, Parama; Chattopadhyay, Sarbani; Mondal, Soumit (2013). "Cervical intramural pregnancy: Report of a rare case". Nigerian Medical Journal. 54 (4): 271. doi:10.4103/0300-1652.119670. ISSN 0300-1652.
  31. . doi:10.12865/CHSJ.42.02.11. Missing or empty |title= (help)
  32. Casey PM, Long ME, Marnach ML (February 2011). "Abnormal cervical appearance: what to do, when to worry?". Mayo Clin. Proc. 86 (2): 147–50, quiz 151. doi:10.4065/mcp.2010.0512. PMC 3031439. PMID 21270291.
  33. Mattson SK, Polk JP, Nyirjesy P (July 2016). "Chronic Cervicitis: Presenting Features and Response to Therapy". J Low Genit Tract Dis. 20 (3): e30–3. doi:10.1097/LGT.0000000000000225. PMID 27243142.
  34. Rosenfeld WD, Clark J (June 1989). "Vulvovaginitis and cervicitis". Pediatr. Clin. North Am. 36 (3): 489–511. PMID 2660084.
  35. Meyer T (August 2016). "Diagnostic Procedures to Detect Chlamydia trachomatis Infections". Microorganisms. 4 (3). doi:10.3390/microorganisms4030025. PMID 27681919.
  36. Woods, Jennifer L.; Bailey, Sarabeth L.; Hensel, Devon J.; Scurlock, Amy M. (2011). "Cervicitis in Adolescents: Do Clinicians Understand Diagnosis and Treatment?". Journal of Pediatric and Adolescent Gynecology. 24 (6): 359–364. doi:10.1016/j.jpag.2011.06.006. ISSN 1083-3188.
  37. Jayakumar, Naveen Kumar Bhagavathula (2015). "Cervicitis: How Often Is It Non-specific!". JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. doi:10.7860/JCDR/2015/11594.5673. ISSN 2249-782X.
  38. Bakour SH, Dwarakanath LS, Khan KS, Newton JR, Gupta JK (May 1999). "The diagnostic accuracy of ultrasound scan in predicting endometrial hyperplasia and cancer in postmenopausal bleeding". Acta Obstet Gynecol Scand. 78 (5): 447–51. PMID 10326893.
  39. Beddy, Peter; O'Neill, Ailbhe C.; Yamamoto, Adam K.; Addley, Helen C.; Reinhold, Caroline; Sala, Evis (2012). "FIGO Staging System for Endometrial Cancer: Added Benefits of MR Imaging". RadioGraphics. 32 (1): 241–254. doi:10.1148/rg.321115045. ISSN 0271-5333.
  40. Byun JM, Jeong DH, Kim YN, Cho EB, Cha JE, Sung MS, Lee KB, Kim KT (November 2015). "Endometrial cancer arising from atypical complex hyperplasia: The significance in an endometrial biopsy and a diagnostic challenge". Obstet Gynecol Sci. 58 (6): 468–74. doi:10.5468/ogs.2015.58.6.468. PMID 26623410.
  41. Wan-Nor-Asyikeen WA, Siti-Azrin AH, Jalil NA, Othman NH, Zain AA (2016). "Endometrial Cancer in Hospital Universiti Sains Malaysia". Asian Pac. J. Cancer Prev. 17 (6): 2867–70. PMID 27356704.
  42. Horn LC, Meinel A, Handzel R, Einenkel J (August 2007). "Histopathology of endometrial hyperplasia and endometrial carcinoma: an update". Ann Diagn Pathol. 11 (4): 297–311. doi:10.1016/j.anndiagpath.2007.05.002. PMID 17630117.
  43. Palmer, Julia E; Perunovic, Branko; Tidy, John A (2008). "Endometrial hyperplasia". The Obstetrician & Gynaecologist. 10 (4): 211–216. doi:10.1576/toag.10.4.211.27436. ISSN 1467-2561.
  44. Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K, Voigt LF, Weiss NS (June 2009). "Incidence of endometrial hyperplasia". Am. J. Obstet. Gynecol. 200 (6): 678.e1–6. doi:10.1016/j.ajog.2009.02.032. PMC 2692753. PMID 19393600.
  45. Novac L, Grigore T, Cernea N, Niculescu M, Cotarcea S (2005). "Incidence of endometrial carcinoma in patients with endometrial hyperplasia". Eur. J. Gynaecol. Oncol. 26 (5): 561–3. PMID 16285581.
  46. Hsu AL, Khachikyan I, Stratton P (June 2010). "Invasive and noninvasive methods for the diagnosis of endometriosis". Clin Obstet Gynecol. 53 (2): 413–9. doi:10.1097/GRF.0b013e3181db7ce8. PMC 2880548. PMID 20436318.
  47. Chamié, Luciana Pardini; Blasbalg, Roberto; Pereira, Ricardo Mendes Alves; Warmbrand, Gisele; Serafini, Paulo Cesar (2011). "Findings of Pelvic Endometriosis at Transvaginal US, MR Imaging, and Laparoscopy". RadioGraphics. 31 (4): E77–E100. doi:10.1148/rg.314105193. ISSN 0271-5333.
  48. Datta S, Kunde K (July 2008). "From vaginal discharge to endometriosis: an unusual case of endometriosis in pregnancy". J Obstet Gynaecol. 28 (5): 552–3. doi:10.1080/01443610802247352. PMID 18850447.
  49. Chamié, Luciana Pardini; Blasbalg, Roberto; Pereira, Ricardo Mendes Alves; Warmbrand, Gisele; Serafini, Paulo Cesar (2011). "Findings of Pelvic Endometriosis at Transvaginal US, MR Imaging, and Laparoscopy". RadioGraphics. 31 (4): E77–E100. doi:10.1148/rg.314105193. ISSN 0271-5333.
  50. Bedaiwy MA, Falcone T (February 2004). "Laboratory testing for endometriosis". Clin. Chim. Acta. 340 (1–2): 41–56. PMID 14734195.
  51. Van Holsbeke C, Van Calster B, Guerriero S, Savelli L, Paladini D, Lissoni AA, Czekierdowski A, Fischerova D, Zhang J, Mestdagh G, Testa AC, Bourne T, Valentin L, Timmerman D (June 2010). "Endometriomas: their ultrasound characteristics". Ultrasound Obstet Gynecol. 35 (6): 730–40. doi:10.1002/uog.7668. PMID 20503240.
  52. . doi:10.1148/rg.314105193. Check |doi= value (help). Missing or empty |title= (help)
  53. Hoenderboom BM, van Benthem B, van Bergen J, Dukers-Muijrers N, Götz HM, Hoebe C, Hogewoning AA, Land JA, van der Sande M, Morré SA, van den Broek I (January 2019). "Relation between Chlamydia trachomatis infection and pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility in a Dutch cohort of women previously tested for chlamydia in a chlamydia screening trial". Sex Transm Infect. doi:10.1136/sextrans-2018-053778. PMID 30606817. Vancouver style error: initials (help)
  54. Jaiyeoba O, Soper DE (2011). "A practical approach to the diagnosis of pelvic inflammatory disease". Infect Dis Obstet Gynecol. 2011: 753037. doi:10.1155/2011/753037. PMC 3148590. PMID 21822367.
  55. Czeyda-Pommersheim, Ferenc; Kalb, Bobby; Costello, James; Liau, Joy; Meshksar, Arash; Arif Tiwari, Hina; Martin, Diego (2016). "MRI in pelvic inflammatory disease: a pictorial review". Abdominal Radiology. 42 (3): 935–950. doi:10.1007/s00261-016-1004-4. ISSN 2366-004X.
  56. Mitchell, Caroline; Prabhu, Malavika (2013). "Pelvic Inflammatory Disease". Infectious Disease Clinics of North America. 27 (4): 793–809. doi:10.1016/j.idc.2013.08.004. ISSN 0891-5520.
  57. Filip G, Balzano A, Cagnacci A (November 2018). "Histological evaluation of the prevalence of adenomyosis, myomas and of their concomitance". Minerva Ginecol. doi:10.23736/S0026-4784.18.04291-0. PMID 30486633.
  58. Fujino T, Watanabe T, Shinmura R, Hahn L, Nagata Y, Hasui K (December 1992). "Acute abdomen due to adenomyosis of the uterus: a case report". Asia Oceania J Obstet Gynaecol. 18 (4): 333–7. PMID 1492806.
  59. Fujino T, Watanabe T, Shinmura R, Hahn L, Nagata Y, Hasui K (December 1992). "Acute abdomen due to adenomyosis of the uterus: a case report". Asia Oceania J Obstet Gynaecol. 18 (4): 333–7. PMID 1492806.
  60. Zhou Y, Wu B, Li H (October 1996). "[The value of serum CA125 assays in the diagnosis of uterine adenomyosis]". Zhonghua Fu Chan Ke Za Zhi (in Chinese). 31 (10): 590–3. PMID 9275451.
  61. Tamai, Ken; Togashi, Kaori; Ito, Tsuyoshi; Morisawa, Nobuko; Fujiwara, Toshitaka; Koyama, Takashi (2005). "MR Imaging Findings of Adenomyosis: Correlation with Histopathologic Features and Diagnostic Pitfalls". RadioGraphics. 25 (1): 21–40. doi:10.1148/rg.251045060. ISSN 0271-5333.
  62. Dartmouth, Katherine (2014). "A systematic review with meta-analysis: the common sonographic characteristics of adenomyosis". Ultrasound. 22 (3): 148–157. doi:10.1177/1742271X14528837. ISSN 1742-271X.
  63. Mouhajer M, Obed S, Okpala AM (June 2017). "Cervical Ectopic Pregnancy in Resource Deprived Areas: A Rare and Difficult Diagnosis". Ghana Med J. 51 (2): 94–97. PMC 5611908. PMID 28955106.
  64. Rathod, Setu; Samal, SunilKumar (2015). "Cervical ectopic pregnancy". Journal of Natural Science, Biology and Medicine. 6 (1): 257. doi:10.4103/0976-9668.149221. ISSN 0976-9668.
  65. Tarney CM, Han J (2014). "Postcoital bleeding: a review on etiology, diagnosis, and management". Obstet Gynecol Int. 2014: 192087. doi:10.1155/2014/192087. PMC 4086375. PMID 25045355.
  66. Miccò, Maura; Sala, Evis; Lakhman, Yulia; Hricak, Hedvig; Vargas, Hebert Alberto (2015). "Imaging Features of Uncommon Gynecologic Cancers". American Journal of Roentgenology. 205 (6): 1346–1359. doi:10.2214/AJR.14.12695. ISSN 0361-803X.
  67. Kim, Hwi-Gon; Song, Yong Jung; Na, Yong Jin; Choi, Ook-Hwan (2013). "A Case of Vaginal Cancer with Uterine Prolapse". Journal of Menopausal Medicine. 19 (3): 139. doi:10.6118/jmm.2013.19.3.139. ISSN 2288-6478.
  68. Karateke A, Tugrul S, Yakut Y, Gürbüz A, Cam C (2006). "Management of a case of primary vaginal cancer with irreducible massive uterine prolapse--a case report". Eur. J. Gynaecol. Oncol. 27 (5): 528–30. PMID 17139994.
  69. van der Linden, M.; Meeuwis, K.A.P.; Bulten, J.; Bosse, T.; van Poelgeest, M.I.E.; de Hullu, J.A. (2016). "Paget disease of the vulva". Critical Reviews in Oncology/Hematology. 101: 60–74. doi:10.1016/j.critrevonc.2016.03.008. ISSN 1040-8428.
  70. Lloyd J, Evans DJ, Flanagan AM (July 1999). "Extension of extramammary Paget disease of the vulva to the cervix". J. Clin. Pathol. 52 (7): 538–40. PMC 501500. PMID 10605411.
  71. Shaco-Levy R, Bean SM, Vollmer RT, Papalas JA, Bentley RC, Selim MA, Robboy SJ (January 2010). "Paget disease of the vulva: a histologic study of 56 cases correlating pathologic features and disease course". Int. J. Gynecol. Pathol. 29 (1): 69–78. doi:10.1097/PGP.0b013e3181b1cc5e. PMID 19952933.
  72. Asmouki, Hamid; Oumouloud, Rachid; Aboulfalah, Abderrahim; Soummani, Abderraouf; Marrat, Abdelouahed (2012). "Paget's Disease of the Vulva in Premenopausal Woman Treated with Only Surgery: A Case Report". Case Reports in Oncological Medicine. 2012: 1–4. doi:10.1155/2012/854827. ISSN 2090-6706.
  73. Gonçalves Amorim, Andressa; Batista Fraga Mendes, Brunelle; Neves Ferreira, Rodrigo; Chambô Filho, Antônio (2015). "Paget Disease of the Vulva: Diagnosis by Immunohistochemistry". Case Reports in Dermatological Medicine. 2015: 1–5. doi:10.1155/2015/162483. ISSN 2090-6463.
  74. Casey PM, Long ME, Marnach ML (February 2011). "Abnormal cervical appearance: what to do, when to worry?". Mayo Clin. Proc. 86 (2): 147–50, quiz 151. doi:10.4065/mcp.2010.0512. PMC 3031439. PMID 21270291.
  75. Bin Park, Sung; Lee, Jong Hwa; Lee, Young Ho; Song, Mi Jin; Choi, Hye Jeong (2010). "Multilocular Cystic Lesions in the Uterine Cervix: Broad Spectrum of Imaging Features and Pathologic Correlation". American Journal of Roentgenology. 195 (2): 517–523. doi:10.2214/AJR.09.3619. ISSN 0361-803X.
  76. Torky, Haitham A. (2016). "Huge Nabothian cyst causing Hematometra (case report)". European Journal of Obstetrics & Gynecology and Reproductive Biology. 207: 238–240. doi:10.1016/j.ejogrb.2016.10.042. ISSN 0301-2115.
  77. Okamoto, Yoshikazu; Tanaka, Yumiko O.; Nishida, Masato; Tsunoda, Hajime; Yoshikawa, Hiroyuki; Itai, Yuji (2003). "MR Imaging of the Uterine Cervix: Imaging-Pathologic Correlation". RadioGraphics. 23 (2): 425–445. doi:10.1148/rg.232025065. ISSN 0271-5333.
  78. Trobough GE (March 1978). "Pelvic pain and the IUD". J Reprod Med. 20 (3): 167–74. PMID 347074.
  79. Nowitzki, Kristina M.; Hoimes, Matthew L.; Chen, Byron; Zheng, Larry Z.; Kim, Young H. (2015). "Ultrasonography of intrauterine devices". Ultrasonography. 34 (3): 183–194. doi:10.14366/usg.15010. ISSN 2288-5919.
  80. . doi:10.5489/cuaj.11100. Check |doi= value (help). Missing or empty |title= (help)
  81. Sánchez Cortés E (July 1965). "[Renal vascular hypertension. Urological diagnosis]". Medicina (Madr) (in Spanish; Castilian). 33 (7): 505–15. PMID 5861413.
  82. . doi:10.1136/bmj.h4579. Check |doi= value (help). Missing or empty |title= (help)
  83. Elsasser DA, Ananth CV, Prasad V, Vintzileos AM (February 2010). "Diagnosis of placental abruption: relationship between clinical and histopathological findings". Eur. J. Obstet. Gynecol. Reprod. Biol. 148 (2): 125–30. doi:10.1016/j.ejogrb.2009.10.005. PMC 2814948. PMID 19897298.
  84. . doi:10.1016/j.ejogrb.2009.10.005. Epub 2009 Nov 7. Check |doi= value (help). Missing or empty |title= (help)
  85. Alouini S, Megier P, Fauconnier A, Huchon C, Fievet A, Ramos A, Megier C, Valéry A (January 2019). "Diagnosis and management of placenta previa and low placental implantation". J. Matern. Fetal. Neonatal. Med.: 1–6. doi:10.1080/14767058.2019.1570118. PMID 30688129.
  86. Kawabe A, Wang L, Kikugawa A, Shibata Y, Kuromaki K, Takagi A (October 2016). "Severe abdominal pain exacerbated by fetal movement is an early sign of the onset of uterine rupture". Taiwan J Obstet Gynecol. 55 (5): 721–723. doi:10.1016/j.tjog.2015.12.021. PMID 27751423.
  87. Biswas R, Sawhney H, Dass R, Saran RK, Vasishta K (March 1999). "Histopathological study of placental bed biopsy in placenta previa". Acta Obstet Gynecol Scand. 78 (3): 173–9. PMID 10078576.
  88. Taran FA, Kagan KO, Hübner M, Hoopmann M, Wallwiener D, Brucker S (October 2015). "The Diagnosis and Treatment of Ectopic Pregnancy". Dtsch Arztebl Int. 112 (41): 693–703, quiz 704–5. doi:10.3238/arztebl.2015.0693. PMC 4643163. PMID 26554319.
  89. Winder S, Reid S, Condous G (May 2011). "Ultrasound diagnosis of ectopic pregnancy". Australas J Ultrasound Med. 14 (2): 29–33. doi:10.1002/j.2205-0140.2011.tb00192.x. PMC 5024893. PMID 28191110.
  90. Virmani S, Srinivas SB, Bhat R, Rao R, Kudva R (July 2017). "Transient Thyrotoxicosis in Molar Pregnancy". J Clin Diagn Res. 11 (7): QD01–QD02. doi:10.7860/JCDR/2017/28561.10133. PMID 28892983.
  91. Jeffers MD, O'Dwyer P, Curran B, Leader M, Gillan JE (October 1993). "Partial hydatidiform mole: a common but underdiagnosed condition. A 3-year retrospective clinicopathological and DNA flow cytometric analysis". Int. J. Gynecol. Pathol. 12 (4): 315–23. PMID 8253548.
  92. Alhamdan D, Bignardi T, Condous G (August 2009). "Recognising gestational trophoblastic disease". Best Pract Res Clin Obstet Gynaecol. 23 (4): 565–73. doi:10.1016/j.bpobgyn.2009.03.001. PMID 19375983.
  93. Cardoso, Mariana Ferreira; Lourenço, Luís Carvalho; Antunes, Margarida; Carvalho e Branco, Joana; Santos, Liliana; Martins, Alexandra; Reis, Jorge A. (2018). "Recurrent Gastrointestinal Bleeding from Dieulafoy's Lesions in a Patient with Type 1 von Willebrand Disease: A Rare Association". GE - Portuguese Journal of Gastroenterology: 1–5. doi:10.1159/000490921. ISSN 2341-4545.
  94. Castaman, Giancarlo; Linari, Silvia (2017). "Diagnosis and Treatment of von Willebrand Disease and Rare Bleeding Disorders". Journal of Clinical Medicine. 6 (4): 45. doi:10.3390/jcm6040045. ISSN 2077-0383.
  95. Budde U (November 2008). "Diagnosis of von Willebrand disease subtypes: implications for treatment". Haemophilia. 14 Suppl 5: 27–38. doi:10.1111/j.1365-2516.2008.01849.x. PMID 18786008.
  96. Al-Shbool G, Vakiti A (2018). "Acquired Hemophilia A Presenting as Intramuscular Hematoma". J Investig Med High Impact Case Rep. 6: 2324709618817572. doi:10.1177/2324709618817572. PMC 6299309. PMID 30574513.
  97. Mansouritorghabeh H (May 2015). "Clinical and laboratory approaches to hemophilia a". Iran J Med Sci. 40 (3): 194–205. PMC 4430880. PMID 25999618.
  98. Kirchmaier CM, Pillitteri D (2010). "Diagnosis and Management of Inherited Platelet Disorders". Transfus Med Hemother. 37 (5): 237–246. doi:10.1159/000320257. PMC 2980508. PMID 21113246.
  99. Hayward CP, Rao AK, Cattaneo M (July 2006). "Congenital platelet disorders: overview of their mechanisms, diagnostic evaluation and treatment". Haemophilia. 12 Suppl 3: 128–36. doi:10.1111/j.1365-2516.2006.01270.x. PMID 16684008.
  100. . doi:10.1111/jth.12555. Check |doi= value (help). Missing or empty |title= (help)
  101. Kanda, Kenji; Kunishima, Shinji; Sato, Aya; Abe, Daisuke; Nishijima, Setsuko; Ishigami, Tsuyoshi (2017). "A Brazilian case of Bernard–Soulier syndrome with two distinct founder mutations". Human Genome Variation. 4: 17030. doi:10.1038/hgv.2017.30. ISSN 2054-345X.
  102. Nurden, Alan T (2006). "Glanzmann thrombasthenia". Orphanet Journal of Rare Diseases. 1 (1). doi:10.1186/1750-1172-1-10. ISSN 1750-1172.
  103. Deshmukh, Prasad; Boricha, B.; Pandey, Ankita (2015). "The association of thyroid disorders with abnormal uterine bleeding". International Journal of Reproduction, Contraception, Obstetrics and Gynecology: 701–708. doi:10.18203/2320-1770.ijrcog20150077. ISSN 2320-1770.
  104. Pishdad P, Pishdad GR, Tavanaa S, Pishdad R, Jalli R (March 2017). "Thyroid Ultrasonography in Differentiation between Graves' Disease and Hashimoto's Thyroiditis". J Biomed Phys Eng. 7 (1): 21–26. PMC 5401130. PMID 28451576.
  105. Deshmukh, Prasad; Boricha, B.; Pandey, Ankita (2015). "The association of thyroid disorders with abnormal uterine bleeding". International Journal of Reproduction, Contraception, Obstetrics and Gynecology: 701–708. doi:10.18203/2320-1770.ijrcog20150077. ISSN 2320-1770.
  106. Pishdad P, Pishdad GR, Tavanaa S, Pishdad R, Jalli R (March 2017). "Thyroid Ultrasonography in Differentiation between Graves' Disease and Hashimoto's Thyroiditis". J Biomed Phys Eng. 7 (1): 21–26. PMC 5401130. PMID 28451576.
  107. Mizukami Y, Michigishi T, Nonomura A, Hashimoto T, Tonami N, Matsubara F, Takazakura E (February 1993). "Iodine-induced hypothyroidism: a clinical and histological study of 28 patients". J. Clin. Endocrinol. Metab. 76 (2): 466–71. doi:10.1210/jcem.76.2.8432791. PMID 8432791.
  108. Lee, Ju-Han; Kim, Younghye; Choi, Jung-Woo; Kim, Young-Sik (2013). "The association between papillary thyroid carcinoma and histologically proven Hashimoto's thyroiditis: a meta-analysis". European Journal of Endocrinology. 168 (3): 343–349. doi:10.1530/EJE-12-0903. ISSN 0804-4643.
  109. Lapcević M (October 2005). "[Autoimmune thyroid disease and associated diseases]". Srp Arh Celok Lek. 133 Suppl 1: 84–7. PMID 16405263.
  110. Vigliani MB, Buster JE (April 2012). "Nonclassic 21-hydroxylase deficiency presenting as endometrial hyperplasia with uterine bleeding in a 67-year-old woman". Fertil. Steril. 97 (4): 950–2. doi:10.1016/j.fertnstert.2012.01.089. PMID 22270556.
  111. Gioco F, Seccia TM, Gomez-Sanchez EP, Rossi GP, Gomez-Sanchez CE (October 2015). "Adrenal histopathology in primary aldosteronism: is it time for a change?". Hypertension. 66 (4): 724–30. doi:10.1161/HYPERTENSIONAHA.115.05873. PMID 26238443.
  112. . doi:10.1515/jpem-2017-0235. Check |doi= value (help). Missing or empty |title= (help)
  113. Choudhary A, Spigland N, Poppas D, Kovanlikaya A, Nimkarn S (February 2013). "Vaginal bleeding leading to incidental diagnosis of ovarian torsion in an infant with 21 hydroxylase deficiency congenital adrenal hyperplasia". J. Pediatr. 162 (2): 432–432.e1. doi:10.1016/j.jpeds.2012.08.026. PMID 23040792.
  114. Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A, Hershman JM, Kaltsas G, Koch C, Kopp P, Korbonits M, McLachlan R, Morley JE, New M, Perreault L, Purnell J, Rebar R, Singer F, Trence DL, Vinik A, Wilson DP, Yau M, New M. PMID 25905311. Missing or empty |title= (help)
  115. Zada, Gabriel (2013). "Diagnosis and Multimodality Management of Cushing's Disease: A Practical Review". International Journal of Endocrinology. 2013: 1–7. doi:10.1155/2013/893781. ISSN 1687-8337.
  116. Olivier L, Vila-Porcile E (September 1988). "Pituitary pathology in Cushing's disease. Histology and morphometry of pituitary tissues removed through microsurgery". Pathol. Res. Pract. 183 (5): 587–91. doi:10.1016/S0344-0338(88)80017-7. PMID 3237548.
  117. Lie Fong, S.; Laven, J.S.E.; Duhamel, A.; Dewailly, D. (2017). "Polycystic ovarian morphology and the diagnosis of polycystic ovary syndrome: redefining threshold levels for follicle count and serum anti-Müllerian hormone using cluster analysis". Human Reproduction. 32 (8): 1723–1731. doi:10.1093/humrep/dex226. ISSN 0268-1161.
  118. Lie Fong S, Laven J, Duhamel A, Dewailly D (August 2017). "Polycystic ovarian morphology and the diagnosis of polycystic ovary syndrome: redefining threshold levels for follicle count and serum anti-Müllerian hormone using cluster analysis". Hum. Reprod. 32 (8): 1723–1731. doi:10.1093/humrep/dex226. PMID 28854584. Vancouver style error: initials (help)
  119. Pembe AB, Abeid MS (October 2009). "Polycystic ovaries and associated clinical and biochemical features among women with infertility in a tertiary hospital in Tanzania". Tanzan J Health Res. 11 (4): 175–80. PMID 20734696.
  120. Fleischman A, Mansfield J (September 2005). "Diagnosis and treatment of polycystic ovarian syndrome and insulin resistance". Pediatr Ann. 34 (9): 733–8, 741–2. PMID 16222950.
  121. McManus, Shilpa; Levitsky, Lynne; Misra, Madhusmita (2013). "Polycystic Ovary Syndrome: Clinical Presentation in Normal-Weight Compared with Overweight Adolescents". Endocrine Practice. 19 (3): 471–478. doi:10.4158/EP12235.OR. ISSN 1530-891X.
  122. Munro, Malcolm G.; Critchley, Hilary O.D.; Broder, Michael S.; Fraser, Ian S. (2011). "FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age". International Journal of Gynecology & Obstetrics. 113 (1): 3–13. doi:10.1016/j.ijgo.2010.11.011. ISSN 0020-7292.
  123. James, A. H. (2016). "Heavy menstrual bleeding: work-up and management". Hematology. 2016 (1): 236–242. doi:10.1182/asheducation-2016.1.236. ISSN 1520-4391.
  124. Bryk AH, Piróg M, Plens K, Undas A (December 2016). "Heavy menstrual bleeding in women treated with rivaroxaban and vitamin K antagonists and the risk of recurrent venous thromboembolism". Vascul. Pharmacol. 87: 242–247. doi:10.1016/j.vph.2016.11.003. PMID 27865826.
  125. Adra, Abdallah; El Zibdeh, Mazen Yousef; Abdul Malek, Abdul Malek Mohammed; Hamrahian, Amir H.; Abdelhamid, Amr Mohamed Salaheldin; Colao, Annamaria; Anastasiades, Elie; Ahmed, Essam Moustafa Aboul Fetooh; Ezzeddine, Jihad Ibrahim; El Sattar, Mahmoud Ibrahim Abd; Dabit, Suleiman Tawfiq; Ghanameh, Wadih; Nedjatian, Navid; El-Kak, Faysal (2016). "Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia". Middle East Fertility Society Journal. 21 (3): 137–147. doi:10.1016/j.mefs.2016.02.001. ISSN 1110-5690.
  126. Shakerinejad, Ghodratollah; Hidarnia, Alireza; Motlagh, Mohammad Esmaeil; Karami, Khodabakhsh; Niknami, Shamsoddin; Montazeri, Ali (2013). "Factors predicting mood changes in oral contraceptive pill users". Reproductive Health. 10 (1). doi:10.1186/1742-4755-10-45. ISSN 1742-4755.
  127. van Hunsel FP, Kampschöer P (2012). "[Postmenopausal bleeding and dietary supplements: a possible causal relationship with hop- and soy-containing preparations]". Ned Tijdschr Geneeskd (in Dutch; Flemish). 156 (41): A5095. PMID 23062258.
  128. Tu, Xiang; Huang, Gaomin; Tan, Shengkui (2009). "Chinese Herbal Medicine for Dysfunctional Uterine Bleeding: A Meta-Analysis". Evidence-Based Complementary and Alternative Medicine. 6 (1): 99–105. doi:10.1093/ecam/nem063. ISSN 1741-427X.
  129. Kabalak AA, Soyal OB, Urfalioglu A, Saracoglu F, Gogus N (September 2004). "Menometrorrhagia and tachyarrhythmia after using oral and topical ginseng". J Womens Health (Larchmt). 13 (7): 830–3. PMID 15385077.



Linked-in.jpg