{'fraction_non_alphanumeric': 0.011840688912809472, 'fraction_numerical': 0.002152852529601722, 'mean_word_length': 5.690647482014389, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 1, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Menorrhagia in the Menopause

Aetiology Menstrual cycle irregularity in the perimenopause is the result of erratic and declining ovarian function because of a gradual depletion of oocytes and decreased sensitivity of the hypothalamic pituitary axis to the positive feedback action of luteinising hormone. The menstrual cycles become shorter by two to seven days because of a shortened follicular phase. This is usually followed by increasing irregularity and unpredictability of bleeding, leading to prolonged intervals of amenorrhoea and the final menstrual bleed. Nonetheless, it is abnormal to have heavy (measured menstrual blood loss >80 ml), or prolonged or intermenstrual bleeding in the perimenopause and further assessment in this situation should therefore be considered to exclude organic pathology. Fourteen per cent of premenopausal women with irregular bleeding may be found to have abnormal endometrial histology.s