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**Overview**: Menorrhagia Screen Panel**Introduction**: The Menorrhagia Screen Panel is a diagnostic tool designed to screen for menorrhagia causes using serum samples. In India, heavy menstrual bleeding (menorrhagia) affects ~20-30 percent of reproductive-age women, contributing to anemia in ~50 percent of cases, with causes including hormonal imbalance (PCOS, anovulation), thyroid dysfunction, hyperprolactinemia, and coagulopathy. High morbidity from under-testing in rural/low-SES women with prolonged bleeding, fatigue, or infertility, limited endocrine labs, delayed hormonal therapy or D&C leading to chronic anemia, school/work absenteeism, or hysterectomy. Per gynecology practices aligned with ICMR, FOGSI, and Indian Society of Obstetrics and Gynaecology guidelines, the test employs immunoassay for FSH, LH, prolactin, TSH, estradiol, progesterone, testosterone, and DHEAS over 1-2 days with high accuracy, valuable for identifying ovulatory dysfunction, PCOS, or thyroid-related causes. This diagnostic falls under hormonal screening and targets women with menorrhagia (>80 mL/cycle or soaking pads hourly), addressing accurate detection to guide OCPs, tranexamic acid, or levonorgestrel IUS. With elevated morbidity due to underdiagnosis, the test supports public health efforts by enabling precise etiological assessment and reducing anemia burden. Its serum-based approach ensures reliable multi-hormone profiling.**Other Names**: Menorrhagia Pnl.**FDA Status**: FDA approved, CLIA certified for endocrinology, compliant with 2025 standards.**Historical Milestone**: Hormonal menorrhagia panel standard; in India, used in gynecology clinics.**Purpose**: The test assesses 8 parameters including FSH to guide menorrhagia screening, identify hormonal causes, inform therapy.**Test Parameters**: 1. FSH, 2. LH, 3. Prolactin, 4. TSH, 5. Estradiol, 6. Progesterone, 7. Testosterone, 8. DHEAS.**Pretest Condition**: Fasting 10-12 hours recommended (day 2-5 of cycle for basal hormones); patients should report heavy bleeding.**Specimen**: 3 mL serum in 1 SST, transported within specified times to maintain sample viability.**Sample Stability at Room Temperature**: 8 hours with proper handling to preserve analyte integrity, ensuring reliable test performance.**Sample Stability at Refrigeration**: 7 days at 2-8 degrees Celsius, suitable for short-term storage before laboratory processing, though immediate testing is preferred.**Sample Stability at Frozen**: 6 months at -20 degrees Celsius, allowing long-term storage for retesting, though freezing may affect some analytes.**Medical History**: Patients should provide details on cycle length, bleeding duration, anemia symptoms.**Consent**: Written informed consent is required, detailing the test's purpose, potential risks of untreated menorrhagia including anemia, benefits of screening, and minimal discomfort from venipuncture.**Procedural Considerations**: The test involves sample processing using immunoassay by trained personnel to ensure sterile technique, avoid hemolysis, and interpret results within 1-2 days using provided controls. Laboratories must maintain a controlled environment, adhere to quality assurance protocols.**Factors Affecting Result Accuracy**: Delays beyond stability periods, improper storage conditions, hemolysis, or incorrect cycle day can affect results. Correlation with clinical evaluation or additional testing is recommended to confirm findings.**Clinical Significance**: Abnormal levels (high prolactin/low TSH) indicate treatable causes, necessitating specialist input.**Specialist Consultation**: Gynecologists or endocrinologists should be consulted for management.**Additional Supporting Tests**: Pelvic ultrasound, coagulation profile for confirmation.**Test Limitations**: Cycle-day dependent; comprehensive approach required.**References**: Indian Journal of Obstetrics and Gynaecology 2024, Menstrual Studies India 2023. |
