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Dysfunctional uterine bleeding (DUB)Definition Dysfunctional uterine bleeding (DUB) is abnormal vaginal bleeding that occurs during a menstrual cycle that produced no egg (ovulation did not take place). Causes, incidence, and risk factors Anovulatory or dysfunctional uterine bleeding is a diagnosis of exclusion. This means that it is determined only AFTER other causes of abnormal uterine bleeding -- such as systemic diseases, medications, early pregnancy disorders, eating disorders, gynecological infections, structural anomalies, or tumors -- have been ruled out. Anovulatory cycles are common for the first year after menarche (when a girl begins to menstruate), and later in life as a woman approaches menopause (when menstrual periods stop). Approximately 20% of cases occur in adolescents and 40% in women over 40. Obesity, excessive exercise, and emotional stress may be risk factors for DUB. Symptoms
Signs and tests A pelvic examination will be performed. Tests to evaluate women with DUB usually include:
Diagnostic procedures that may be performed include:
Treatment Young women within several years of menarche (the first menstrual period) are not treated unless symptoms are exceptionally severe, such as heavy blood loss causing anemia. In women of childbearing age, treatment is aimed at achieving regular menstrual cycles with normal patterns. Oral contraceptives or progestogen therapy are frequently used for this purpose. If anemia is present, iron supplementation may be recommended. If pregnancy is desired, ovulation induction may be attempted with medication. Women whose symptoms are severe and resistant to medical therapy may choose surgical treatments including endometrial ablation (a procedure that burns or removes the lining of the uterus) or hysterectomy. In older women who may be approaching menopause, treatment may be elected to offset symptoms. Women may choose from treatments such as hormone supplementation or surgery. Expectations (prognosis) Hormonal regulation is usually successful in alleviating symptoms. Induced ovulation, in women desiring pregnancy, is successful in approximately 80% of cases. Complications
Calling your health care provider Call your health care provider if you have unusual vaginal bleeding. Illustrations
Page Content: Anovulatory bleeding; Bleeding - dysfunctional uterine; DUB ; anovulatory bleeding; dysfunctional uterine bleeding; dysfunctional uterine bleeding treatment |
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