Menstrual disorders and abnormal uterine bleeding aub are among the most frequent gynecologic complaints in adolescents. Feb 03, 2020 what is dysfunctional uterine bleeding. Dysfunctional uterine bleeding dub is the major cause of heavy menstrual bleeding and impacts on womens health both medically and socially. Menstruation, or period, is a womans monthly bleeding. Clinical practice clinical update dysfunctional uterine. It is a diagnosis of exclusion made after structural causes of bleeding and chronic medical diseases have been ruled out. Acute heavy menstrual bleeding may present in the context of existing chronic aub or can occur in the absence of such a background history.
A common and often debilitating condition, affecting women of reproductive age. Dysfunctional uterine bleeding in adolescent girls and evaluation of their response to treatment. Dysfunctional uterine bleeding dub is often caused by a hormonal imbalance. Aub is described by a variety of terms and may be caused by a number of genital and nongenital tract diseases, systemic disorders, and medications. Dysfunctional uterine bleeding diagnostics and treatment. Abnormal uterine bleeding due to ovulatory dysfunction aubo is abnormal uterine bleeding that, after examination and ultrasonography, cannot be attributed to the usual causes structural gynecologic abnormalities, cancer, inflammation, systemic disorders, pregnancy, complications of pregnancy, use of oral contraceptives or certain drugs. Treatment of abnormal uterine bleeding depends on multiple factors, such as the etiology of the aub, fertility desire. Use of intravenous premarin in the treatment of dysfunctional uterine bleeding a. In most women, abnormal uterine bleeding is caused by a hormone imbalance. Pdf abnormal uterine bleeding is one of the most common problems in women of reproductive age, and dysfunctional uterine bleeding dub accounts for. Ovulatory dysfunctional uterine bleeding occurs secondary to defects in local endometrial hemostasis. Abnormal uterine bleeding previously, dysfunctional uterine bleeding dub is irregular uterine bleeding that happens in the absence of recognizable pelvic pathology, basic medical disease, or pregnancy. Endometrial cancer is rare in 15 to 18 years old females.
Dysfunctional uterine bleeding is irregular andor prolonged vaginal bleeding in the absence of structural pelvic pathology. Dec 07, 2018 dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of pathology or medical illness. Variations of normal and minor abnormalities box 5. Evaluation and management of abnormal uterine bleeding in. Surgical treatments include endometrial ablation and hysterectomy. The diagnosis and treatment of dysfunctional uterine bleeding can be a long emotional journey for the patient and a difficult challenge for the provider. Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. Abnormal uterine bleeding symptoms, diagnosis and treatment.
Abnormal uterine bleeding due to ovulatory dysfunction aubo. Howeve r, there are rare hormonal conditions that cause abnormal uterine bleeding in ovulatory cycles. If the cause of dysfunctional uterine bleeding is another medical condition, treating that condition should restore normal cycles. Know the types, causes, symptoms, treatment and diagnosis of. Know the types, causes, symptoms, treatment and diagnosis of dysfunctional uterine bleeding. You may have bleeding from your uterus at times other than your normal monthly period. The most definitive surgical treatment for abnormal uterine bleeding is hysterectomy, or removal of the entire uterus.
Ovulatory abnormal uterine bleeding, or menorrhagia, presents as bleeding that occurs at normal, regular intervals but that is excessive in volume or duration. Dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to. Abnormal uterine bleeding due to ovulatory dysfunction. Aub frequently coexists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a. Aub refers to bleeding that is excessive or occurs outside of normal cyclic menstruation.
Rapid saturation of the endometrium with progestogens seems to be an highly effective mode of treatment for excessive dysfunctional uterine bleeding in. All these conditions associated with menorrhagia can be referred to as dysfunctional uterine bleeding, although it is also possible to have some conditions such as fibroids or an anatomical abnormality with normal menses. Pdf treatment options for dysfunctional uterine bleeding. Abnormal uterine bleeding between menarche and menopause figure 2. Endometrial ablation techniques in the treatment of dysfunctional. Dysfunctional uterine bleeding is basically abnormal vaginal bleeding in the reproductive years of a woman. Dysfunctional uterine bleeding dub treatment, symptoms. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. Pdf hysterectomy as treatment for dysfunctional uterine. Abnormal uterine bleeding is a diagnosis of exclusion in which there is abnormal bleeding i. May 29, 2018 dysfunctional uterine bleeding is basically abnormal vaginal bleeding in the reproductive years of a woman. Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. Dysfunctional uterine bleeding acne, depression, weight gain, oily hair and voice changes. Loss of uterus can be synonymous with loss of femininity.
Dysfunctional uterine bleeding occurs during the reproductive years unrelated to structural uterine abnormalities. Abnormal uterine bleeding due to ovulatory dysfunction is the most common cause of abnormal uterine bleeding. Its most common during puberty and menopause, but can occur at any time during a womans life. Discussion dysfunctional uterine bleeding is defined as heavy menstrual uterine bleeding not due to any recognisable cause and is therefore a. It may be associated with structural or systemic abnormalities. It reflects an interruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause. Progestogens with or without oestrogen for irregular uterine bleeding associated with anovulation. Abnormal uterine bleeding aub may be acute or chronic and is defined as bleeding from the uterine corpus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy 1 2. Once the acute episode of bleeding has been controlled, multiple treatment options are available for longterm treatment of chronic aub.
The relationship between age and various causes of abnormal uterine bleeding. Depending on the age of the patient and her history of sexual activity, the following studies should be considered. Significant correlation was identified between the initial haemoglobin concentration and the time required for cessation of bleeding r0. In cases of acute and severe bleeding, women may need urgent treatment with. Jan 28, 2017 abnormal uterine bleeding previously, dysfunctional uterine bleeding dub is irregular uterine bleeding that happens in the absence of recognizable pelvic pathology, basic medical disease, or pregnancy. It is a difficult condition for the woman, mentally as well as socially and also financially. In this chapter, we will discuss how to manage all the possible causes of dub and, finally, summarise a complete overview of the possible treatments. Abnormal uterine bleeding dysfunctional uterine bleeding ncbi. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. Guidelines for the management of abnormal uterine bleeding. Dysfunctional uterine bleeding dub, the most common cause of abnormal uterine bleeding, occurs most often in women 45 50% of cases and in adolescents 20% of cases. Dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of pathology or medical illness. Jan 01, 2012 there is little consensus on specific treatment regimens for anovulatory uterine bleeding. Abnormal uterine bleeding murtaghs general practice, 7e.
The focus in this policy is on treatment options when the bleeding pattern is abnormal. Feb 06, 2020 dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. Hormones are bad for your health, fattening, they give cancer, reduce libido. It is estimated that 5% of women between the ages 30 and 49 will seek treatment each year for dysfunctional uterine bleeding dub. Dysfunctional uterine bleeding or also known as dub with icd 9 code.
Dysfunctional uterine bleeding in adolescent girls and. Dysfunctional uterine bleeding dub is a gynecologic problem that occurs often during adolescence and is the most frequent cause of. Timely treatment of dysfunctional uterine bleeding is necessary to prevent infertility and anemia. Problem bleeding is among the most common gynecologic complaints of reproductive age women in ambulatory care settingsof similar frequency to the number seeking care for urinary tract infections and vaginitis. Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding is more common in the extremes of the reproductive era, while the incidence of cancer as a cause of bleeding is greatest in the perimenopausal and postmenopausal phases.
Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual. This will depend on the cause of the abnormal uterine bleeding if a chronic illness or a blood disorder is at the root of your symptoms, treating that can help. It also includes bleeding that happens before puberty or after menopause. Abnormal uterine bleeding aub is a common problem among women in the reproductive age. Dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Dose medroxyprogesterone acetate for the treatment of. The most common complaint is continuous, painless vaginal bleeding. Dysfunctional uterine bleeding is more common in the extremes of the reproductive era, while the incidence of cancer as a cause of bleeding is greatest in the perimenopausal and. Abnormal uterine bleeding is defined as excessive, erratic, or irregular bleeding in the presence or absence of intracavitary or uterine pathology. Dysfunctional uterine bleeding is most commonly associated with chronic anovulation. Request pdf dysfunctional uterine bleeding diagnostics and treatment dysfunctional uterine bleeding dub occurs frequently in women at the reproductive age and is unrelated to structural. Treatment options for dysfunctional uterine bleeding. Terms used to describe patterns of abnormal uterine bleeding are based on periodicity and.
Otherwise, treatment is based on the cause, the amount of bleeding and the womans reproductive goals whether she wants to have children or not. Aub may be accompanied by pain and discomfort, cause significant social embarrassment, and have a substantial effect on healthrelated quality of life. Effective medical therapies include the levonorgestrel intrauterine system, ocs monthly or extended cycles, progestin therapy oral or intramuscular, tranexamic acid, and nonsteroidal antiinflammatory drugs 6. Anovulatory or dysfunctional uterine bleeding dub dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to structural abnormalities of the uterus or the endometrial lining. Nursing care plan dysfunctional uterine bleeding vylyz0yzze4m. When hormones are the problem, doctors call the problem dysfunctional uterine bleeding, or dub. What is dysfunctional uterine bleedingtypescausessymptoms. The two figo systems for normal and abnormal uterine. Dysfunctional uterine bleeding what you need to know. Most adolescents with dysfunctional uterine bleeding can be treated safely with hormone therapy and. Rapid saturation of the endometrium with progestogens seems to be an highly effective mode of treatment for excessive dysfunctional uterine bleeding in adolescents. Dysfunctional uterine bleeding dub is abnormal uterine bleeding that is caused by a problem with your hormones. Hysterectomy as treatment for dysfunctional uterine bleeding. Aub system 1 is seen in figure 1, with changes summarized in table 1.
Aub frequently coexists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint. Management of acute abnormal uterine bleeding in nonpregnant. Abnormal uterine bleeding american family physician. Aub leads to loss of productivity1 and may result in surgical interventions including hysterectomy2. Evaluation for systemic cause of abnormal uterine bleeding box 6. Hysterectomy may be performed by conventional laparoscopy or robotic laparoscopy belly button surgery, through the vagina, or by an open incision on. Dysfunctional uterine bleeding an overview sciencedirect. The management of dysfunctional uterine bleeding glowm.
Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. Abnormal uterine bleeding is a common reason for women of all ages to consult their family physicians. Danazol is also used as a 6 week treatment before endometrial ablation. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular.
This article provides nps with a practical overview of the process from chief complaint to followup care. Absence of periods is bad for your health and can be fattening. Management of abnormal uterine bleeding in reproductive period. Abnormal uterine bleeding aub is any variance of the normal menstrual cycle, which is defined on the basis of four parameters frequency, regularity, duration, and volume. Abnormal uterine bleeding aub may be acute or chronic and is defined as. In the general population, abnormal uterine bleeding is estimated to affect 11 to percent of reproductive age women at any given time. Acute aub refers to an episode of heavy bleeding that, in the opinion of the clinician, is of sufficient quantity to require immediate intervention to prevent further blood loss 1. Abnormal uterine bleeding is a common condition, with a prevalence of 10% to 30% among women of reproductive age.
Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. The term dysfunctional uterine bleeding dub has been used previously to define a diagnosis where there was no systemic or locally definable structural cause for the abnormal bleeding 2. At the time of hysterectomy, the ovaries may be left in place or removed. Abnormal uterine bleeding geneva foundation for medical.
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