Management of acute abnormal uterine bleeding in nonpregnant. Dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of pathology or medical illness. Ovulatory abnormal uterine bleeding, or menorrhagia, presents as bleeding that occurs at normal, regular intervals but that is excessive in volume or duration. Hysterectomy may be performed by conventional laparoscopy or robotic laparoscopy belly button surgery, through the vagina, or by an open incision on. Endometrial ablation techniques in the treatment of dysfunctional. Dysfunctional uterine bleeding in adolescent girls and evaluation of their response to treatment. Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. 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. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. It is a diagnosis of exclusion made after structural causes of bleeding and chronic medical diseases have been ruled out. 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.
Most adolescents with dysfunctional uterine bleeding can be treated safely with hormone therapy and. Dysfunctional uterine bleeding dub is abnormal uterine bleeding that is caused by a problem with your hormones. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. Know the types, causes, symptoms, treatment and diagnosis of dysfunctional uterine bleeding. Howeve r, there are rare hormonal conditions that cause abnormal uterine bleeding in ovulatory cycles. Dysfunctional uterine bleeding what you need to know. It reflects an interruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining.
Abnormal uterine bleeding due to ovulatory dysfunction is the most common cause of abnormal uterine bleeding. Jan 01, 2012 there is little consensus on specific treatment regimens for anovulatory uterine bleeding. Progestogens with or without oestrogen for irregular uterine bleeding associated with anovulation. In the general population, abnormal uterine bleeding is estimated to affect 11 to percent of reproductive age women at any given time. 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. Dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to. Pdf hysterectomy as treatment for dysfunctional uterine. Dysfunctional uterine bleeding is basically abnormal vaginal bleeding in the reproductive years of a woman.
Guidelines for the management of abnormal uterine bleeding. It also includes bleeding that happens before puberty or after menopause. The relationship between age and various causes of abnormal uterine bleeding. Abnormal vaginal bleeding is different from normal menstrual periods. Clinical practice clinical update dysfunctional uterine. Feb 06, 2020 dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle.
Dec 07, 2018 dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of pathology or medical illness. 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. Abnormal uterine bleeding aub is a common problem among women in the reproductive age. It could be bleeding that is between periods, is very heavy, or lasts much longer than usual. Dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Dysfunctional uterine bleeding dub is a gynecologic problem that occurs often during adolescence and is the most frequent cause of. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular. Discussion dysfunctional uterine bleeding is defined as heavy menstrual uterine bleeding not due to any recognisable cause and is therefore a. The normal cycle is triggered by signals from hormones. It is estimated that 5% of women between the ages 30 and 49 will seek treatment each year for dysfunctional uterine bleeding dub. When hormones are the problem, doctors call the problem dysfunctional uterine bleeding, or dub.
Feb 03, 2020 what is dysfunctional uterine bleeding. Treatment options for dysfunctional uterine bleeding. Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual. Acute heavy menstrual bleeding may present in the context of existing chronic aub or can occur in the absence of such a background history. Dysfunctional uterine bleeding diagnostics and treatment. 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. Aub leads to loss of productivity1 and may result in surgical interventions including hysterectomy2. 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. You may have bleeding from your uterus at times other than your normal monthly period. Use of intravenous premarin in the treatment of dysfunctional uterine bleeding a. It is a difficult condition for the woman, mentally as well as socially and also financially. Abnormal uterine bleeding due to ovulatory dysfunction.
Abnormal uterine bleeding is a diagnosis of exclusion in which there is abnormal bleeding i. Terms used to describe patterns of abnormal uterine bleeding are based on periodicity and. 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. The most definitive surgical treatment for abnormal uterine bleeding is hysterectomy, or removal of the entire uterus. Surgical treatments include endometrial ablation and hysterectomy. Aub may be accompanied by pain and discomfort, cause significant social embarrassment, and have a substantial effect on healthrelated quality of life. Dose medroxyprogesterone acetate for the treatment of. Abnormal uterine bleeding between menarche and menopause figure 2. Know the types, causes, symptoms, treatment and diagnosis of. Abnormal uterine bleeding due to ovulatory dysfunction aubo. 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. Endometrial cancer is rare in 15 to 18 years old females.
Pdf abnormal uterine bleeding is one of the most common problems in women of reproductive age, and dysfunctional uterine bleeding dub accounts for. Rapid saturation of the endometrium with progestogens seems to be an highly effective mode of treatment for excessive dysfunctional uterine bleeding in adolescents. This article provides nps with a practical overview of the process from chief complaint to followup care. Dysfunctional uterine bleeding dub treatment, symptoms. Aub refers to bleeding that is excessive or occurs outside of normal cyclic menstruation. Abnormal uterine bleeding is a common reason for women of all ages to consult their family physicians. The diagnosis and treatment of dysfunctional uterine bleeding can be a long emotional journey for the patient and a difficult challenge for the provider. Dysfunctional uterine bleeding is irregular andor prolonged vaginal bleeding in the absence of structural pelvic pathology. Evaluation and management of abnormal uterine bleeding in. Dysfunctional uterine bleeding occurs during the reproductive years unrelated to structural uterine abnormalities. 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. Abnormal uterine bleeding murtaghs general practice, 7e. Abnormal uterine bleeding geneva foundation for medical.
Pdf treatment options for dysfunctional uterine bleeding. Abnormal uterine bleeding aub is a common and debilitating condition with high direct and indirect costs. Abnormal uterine bleeding symptoms, diagnosis and treatment. Depending on the age of the patient and her history of sexual activity, the following studies should be considered. Timely treatment of dysfunctional uterine bleeding is necessary to prevent infertility and anemia. Primary care management of abnormal uterine bleeding aub. It may be associated with structural or systemic abnormalities. 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.
If the cause of dysfunctional uterine bleeding is another medical condition, treating that condition should restore normal cycles. In most women, abnormal uterine bleeding is caused by a hormone imbalance. Abnormal uterine bleeding dysfunctional uterine bleeding ncbi. Abnormal uterine bleeding is defined as excessive, erratic, or irregular bleeding in the presence or absence of intracavitary or uterine pathology. 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. 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. Dysfunctional uterine bleeding or also known as dub with icd 9 code. Dysfunctional uterine bleeding in adolescent girls and. The focus in this policy is on treatment options when the bleeding pattern is abnormal. Treatment of abnormal uterine bleeding depends on multiple factors, such as the etiology of the aub, fertility desire. 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. 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. Menstrual disorders and abnormal uterine bleeding aub are among the most frequent gynecologic complaints in adolescents.
Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. 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. The two figo systems for normal and abnormal uterine. Once the acute episode of bleeding has been controlled, multiple treatment options are available for longterm treatment of chronic aub. Dysfunctional uterine bleeding and uterine fibroids. Menstruation, or period, is a womans monthly bleeding. Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. Abnormal uterine bleeding is a common condition, with a prevalence of 10% to 30% among women of reproductive age. The management of dysfunctional uterine bleeding glowm. Abnormal uterine bleeding american family physician. Aub system 1 is seen in figure 1, with changes summarized in table 1. Dysfunctional uterine bleeding an overview sciencedirect. In cases of acute and severe bleeding, women may need urgent treatment with.
Dysfunctional uterine bleeding acne, depression, weight gain, oily hair and voice changes. Dysfunctional uterine bleeding is most commonly associated with chronic anovulation. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause. A common and often debilitating condition, affecting women of reproductive age. Danazol is also used as a 6 week treatment before endometrial ablation. Absence of periods is bad for your health and can be fattening. Nursing care plan dysfunctional uterine bleeding vylyz0yzze4m. 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. Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. Variations of normal and minor abnormalities box 5.
Hysterectomy as treatment for dysfunctional uterine bleeding. Rapid saturation of the endometrium with progestogens seems to be an highly effective mode of treatment for excessive dysfunctional uterine bleeding in. 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. Otherwise, treatment is based on the cause, the amount of bleeding and the womans reproductive goals whether she wants to have children or not. At the time of hysterectomy, the ovaries may be left in place or removed. 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.
Significant correlation was identified between the initial haemoglobin concentration and the time required for cessation of bleeding r0. What is dysfunctional uterine bleedingtypescausessymptoms. Hormones are bad for your health, fattening, they give cancer, reduce libido. As a result, in ovulatory dysfunctional uterine bleeding, treatment with prostaglandin synthetase inhibitors are more effective than hormonal treatment. Dysfunctional uterine bleeding is classified into anovulatory and ovulatory dub. The most common complaint is continuous, painless vaginal bleeding. Evaluation for systemic cause of abnormal uterine bleeding box 6. Dysfunctional uterine bleeding dub is the major cause of heavy menstrual bleeding and impacts on womens health both medically and socially.
May 29, 2018 dysfunctional uterine bleeding is basically abnormal vaginal bleeding in the reproductive years of a woman. 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. Loss of uterus can be synonymous with loss of femininity. Its most common during puberty and menopause, but can occur at any time during a womans life. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. Abnormal uterine bleeding aub may be acute or chronic and is defined as.
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