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Gynekologiske blødningsforstyrrelser

Sist oppdatert: Sist revidert:
Sist revidert av:
  1. Munro MG, Critchley HOD, Fraser IS et al. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynecol Obstet 2018; 143: 393-408. pmid:30198563 PubMed  
  2. Norsk gynekologisk forening. Veileder i gynekologi (2021). Gynekologiske blødningsforstyrrelser. Siden besøkt feb 2022. www.legeforeningen.no  
  3. Knol HM, Mulder AB, Bogchelman DH et al. The prevalence of underlying bleeding disorders in patients with heavy menstrual bleeding with and without gynecologic abnormalities. Am J Obstet Gynecol. 2013;209:202.e1-7. PMID: 23727521. PubMed  
  4. Jacobson AE, Vesely SK, Koch T, et al. Patterns of von Willebrand Disease Screening in Girls and Adolescents With Heavy Menstrual Bleeding. Obstet Gynecol 2018. pmid:29742662 PubMed  
  5. Warner PE, Critchley HO, Lumsden MA, Campbell-Brown M, Douglas A, Murray GD. Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data. Am J Obstet Gynecol 2004; 190: 1216-23. PubMed  
  6. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. NICE guideline NG88. Published date: March 2018 Last updated: November 2018. Cited Dec 2019. www.nice.org.uk  
  7. Norsk gynekologisk forening. Gjør kloke valg. Publisert 13.06.2019. www.legeforeningen.no  
  8. Yoon SW, Lee C, Cha SH, et al. Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI. Eur Radiol 2008; 18: 2997-3006. PubMed  
  9. Davis E, Sparzak PB. Abnormal Uterine Bleeding (Dysfunctional Uterine Bleeding). StatPearls Internet. Treasure Island (FL). Last update 2019 Aug 2. Cited 2019 Dec 17. PMID: 30422508 PubMed  
  10. Wouk N, Helton M. Abnormal Uterine Bleeding in Premenopausal Women. Am Fam Phys 2019; 99: 435-43. pmid:30932448 PubMed  
  11. Bofill Rodriguez M, Lethaby A, Low C, Cameron IT. Cyclical progestogens for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2019, Issue 8. Art. No.: CD001016. DOI: 10.1002/14651858.CD001016.pub3 DOI  
  12. Roberts TE, Tsourapas A, Middleton LJ, et al. Hysterectomy, endometrial ablation, and levonorgestrel releasing intrauterine system (Mirena) for treatment of heavy menstrual bleeding: cost effectiveness analysis. BMJ 2011; 342: D2202. BMJ (DOI)  
  13. Lethaby A, Wise MR, Weterings MAJ et al. Combined hormonal contraceptives for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2019, Issue 2. Art. No.: CD000154. DOI: 10.1002/14651858.CD000154.pub3. The Cochrane Library  
  14. Heliovaara-Peippo S, Hurskainen R, Teperi J, et al. Quality of life and costs of levonorgestrel-releasing intrauterine system or hysterectomy in the treatment of menorrhagia: a 10-year randomized controlled trial. Am J Obstet Gynecol 2013 Dec;209(6):535.e1-535.e14.
  15. Bofill Rodriguez M, Lethaby A, Jordan V. Progestogen-releasing intrauterine systems for heavy menstrual bleeding. Cochrane Database Syst Rev. 2020 Jun 12;6:CD002126. doi: 10.1002/14651858.CD002126.pub4. DOI  
  16. Kaunitz AM, Bissonnette F, Monteiro I, et al. Levonorgestrel-releasing intrauterine system or medroxyprogesterone for heavy menstrual bleeding: a randomized controlled trial. Obstet Gynecol 2010; 116: 625-32. PubMed  
  17. Gupta J, Kai J, Middleton L, et al. Levonorgestrel intrauterine system versus medical therapy for menorrhagia. N Engl J Med 2013; 368: 128-37. New England Journal of Medicine  
  18. Bryant‐Smith AC, Lethaby A, Farquhar C, Hickey M. Antifibrinolytics for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD000249. DOI: 10.1002/14651858.CD000249.pub2. The Cochrane Library  
  19. Bofill Rodriguez M, Lethaby A, Farquhar C. Non‐steroidal anti‐inflammatory drugs for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2019, Issue 9. Art. No.: CD000400. DOI: 10.1002/14651858.CD000400.pub4. The Cochrane Library  
  20. Kuppermann M, Varner RE, Summitt RL, et al. Effect of hysterectomy vs medical treatment on health-related quality of life and sexual functioning. The medicine or surgery (Ms) randomized trial. JAMA 2004; 291:1447-455. Journal of the American Medical Association  
  21. Sowter MC, Lethaby A, Singla AA. Pre-operative endometrial thinning agents before endometrial destruction for heavy menstrual bleeding. Cochrane Database Syst Rev, 15 Nov 2013. CD010241.pub2 Cochrane (DOI)  
  22. Bofill Rodriguez M, Lethaby A, Grigore M, Brown J, Hickey M, Farquhar C. Endometrial resection and ablation techniques for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2019, Issue 1. Art. No.: CD001501. DOI: 10.1002/14651858.CD001501.pub5. The Cochrane Library  
  23. Eraker R, Gravdal LC. Veileder i gynekologi. Gynekologiske blødningsforstyrrelser. Sist rev. 2015.
  24. Royal College of Obstetricians and Gynaecologists. National evidence-based clinical guidelines: the management of menorrhagia in secondary care. Accessed January 23, 2007, at: http://www.rcog.org.uk/index/asp?PageID=692.
  25. Sambrook AM, Elders A, Cooper KG. Microwave endometrial ablation versus thermal balloon endometrial ablation (MEATBall): 5-year follow up of a randomised controlled trial. BJOG 2014. pmid: 24506529 PubMed  
  26. Fergusson RJ, Lethaby A, Shepperd S, Farquhar C. Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2013, Issue 11. Art. No.: CD000329.pub2. The Cochrane Library  
  27. Middleton LJ, Champaneria R, Daniels JP, et al. Hysterectomi, endometrial destruction, and levonorgestrel releasing intrauterine system (Mirena) for heavy menstrual bleeding: systematic review and meta-analysis of data from individual patients. BMJ 2010; 341: c3771. pmid: 20713583 PubMed  
  • Silje Folven Barlindhaug, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Per Bergsjø, professor emeritus, dr. med., Universitetet i Bergen. Spesialist i kvinnesykdommer og fødselshjelp, forsker ved Nasjonalt folkehelseinstitutt, Oslo
  • Mette Haase Moen, førsteamanuenses dr. med. ved Norges teknisk-naturvitenskapelige universitet og overlege ved Kvinneklinikken St. Olavs Hospital, Trondheim