You may have bleeding from your uterus at times other than your normal monthly period. Abnormal uterine bleeding murtaghs general practice, 7e. The high estrogen level is not balanced by an appropriate level of progesterone. 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. This includes procedures that use a resectoscope to surgically remove, electrically desiccate or vaporize the endometrium, as well as laser destruction of the. Dysfunctional uterine bleeding an overview sciencedirect. See nonpregnant vaginal bleeding for the general approach. It is very common in adolescents and is a clinical diagnosis. Most of the time, dub isnt something to worry about. Dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Pdf dysfunctional uterine bleeding dub represents a particular type of abnormal uterine bleeding aub, and is defined in the usa as an excessive. The normal cycle is triggered by signals from hormones.
Most commonly, dysfunctional uterine bleeding dub is due to an immature hypothalamuspituitaryovarian axis leading to anovulatory cycles. In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable. Management of abnormal uterine bleeding associated with ovulatory dysfunction. The term dysfunctional uterine bleeding dub often is substituted, although true dub implies bleeding that is not due to underlying anatomic abnormalities or sys. Abnormal uterine bleeding formerly, dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. Dysfunctional uterine bleeding describes the spectrum of abnormal. The diagnosis of dub depends on a thorough history and physical examination to exclude organic disorders. Aetiology of abnormal uterine bleeding general causes local causes dysfunctional 1. Abnormal uterine bleeding is bleeding from the vagina that occurs frequently or irregularly or lasts longer or is heavier than normal menstrual periods. Dysfunctional uterine bleeding dub linkedin slideshare. Dysfunctional uterine bleeding pdf 59kb pdf back issue. Definition dysfunctional uterine bleeding is condition where there is abnormal uterine bleeding without any pathological manifestation in genital tract and does not have a known organic cause.
Evaluation and management of abnormal uterine bleeding in premenopausal women. In the meantime the article is available for download below. Abnormal dysfunctional uterine bleeding dub in adolescents symptoms and treatment see online here abnormal menstrual bleeding is a common problem faced by adolescent girls after menarche. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. Clinical practice clinical update dysfunctional uterine. Abnormal uterine bleeding aub womens health issues. Dysfunctional uterine bleeding definition of dysfunctional. Click related term for dysfunctional uterine bleeding. Jul 19, 2014 dysfunctional uterine bleeding anovulatory estrogen withdrawal estrogen breakthrough threshold bleeding suprathreshold bleeding progesterone breakthrough ovulatory irregular ripening irregular shedding abnormal local haemostatic mechanisms 31. Abnormal uterine bleeding occurs when either the frequency or quantity of uterine.
Abnormal uterine bleeding abnormal uterine bleeding dr. Jan 01, 2012 abnormal uterine bleeding occurs in 9 to 14 percent of women between menarche and menopause, significantly impacting quality of life and imposing financial burden. Abnormal uterine bleeding is a common, debilitating condition. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular. It may include menorrhagia heavy bleeding at regular intervals. Abnormal uterine bleeding is a common but complicated clinical presentation that impairs the quality of life in women. National collaborating centre for womens and childrens health, national institute of clinical excellence.
Abnormal uterine bleeding aub, also known as atypical vaginal bleeding, is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long, is heavier than normal, or is irregular. Clinical practice clinical update d ysfunctional uterine bleeding dub is defined as excessively heavy, prolonged or frequent bleeding of uterine origin that is not due to pregnancy or any recognisable pelvic or systemic disease. Dysfunctional uterine bleeding, ectopic, vaginal bleeding contents. Jun 21, 2016 definition dysfunctional uterine bleeding is condition where there is abnormal uterine bleeding without any pathological manifestation in genital tract and does not have a known organic cause. Diagnosis and management of formerly called dysfunctional. Feb 03, 2020 dysfunctional uterine bleeding dub is abnormal uterine bleeding that is caused by a problem with your hormones.
Dysfunctional uterine bleeding anovulatory estrogen withdrawal estrogen breakthrough threshold bleeding suprathreshold bleeding progesterone breakthrough ovulatory irregular ripening irregular shedding abnormal local haemostatic mechanisms 31. The mechanisms for the abnormal bleeding and the site from which it. Description dysfunctional uterine bleeding dub is a disorder that occurs most frequently in women at the beginning and end of their reproductive lives. 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.
Dysfunctional uterine bleeding dub is defined as abnormal uterine bleeding that results from an ovarian endocrinopathy. Dec 07, 2018 abnormal uterine bleeding formerly, dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. Abnormal vaginal bleeding in adolescents susan hayden gray. Dysfunctional uterine bleeding dub is abnormal uterine bleeding that is caused by a problem with your hormones. Perimenopausal dysfunctional uterine bleeding the perimenopause is the time prior to the natural cessation of menses when many changes occur due to the absence of ovulation and decreased estrogen production. It may be associated with ovulatory and anovulatory cycles. What is the treatment for dysfunctional uterine bleeding. Doctors also sometimes call dub abnormal uterine bleeding aub. Abnormal uterine bleeding american family physician. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. Polyps or fibroids small and large growths in the uterus can also cause bleeding. It is estimated that 5% of women between the ages 30 and 49 will seek treatment each year for dysfunctional uterine bleeding dub. A reproductiveaged woman presented abnormal uterine bleeding of unknown reason with a heavy bleeding intermenstrual period. Your monthly periods may last longer or shorter, and bleeding may be.
Dub has been observed in both ovulatory and anovulatory cycles. Dysfunctional uterine bleeding dub is irregular vaginal bleeding caused by changes in hormone levels. Medical management of anovulatory dysfunctional uterine bleeding may. Weusethetermabnormalvaginalbleedingtorefer to all cases of irregular, heavy, or frequent bleeding. Dysfunctional uterine bleeding dub is the diagnosis given to women with abnormal uterine bleeding in whom no clear etiology can be identified. In such cases, no egg is released, and the lining of the uterus endometrium may continue to thicken instead of breaking down and being shed. Dysfunctional uterine bleeding this diagnosis should be used only when all organic causes are ruledout, which generally does not occur in the ed. When this happens, your periods may come less than 21 days apart, or more than 35 days apart. The common causes in women of reproductive age include pregnancy and pregnancyrelated disorders, medications, iatrogenic causes, systemic conditions, genital tract pathology, and dysfunctional uterine bleeding anovulatory or ovulatory. Iron deficiency anemia may occur and quality of life may.
Dysfunctional uterine bleeding dub is the name doctors use to describe when something isnt quite right with a girls periods. Chronic abnormal uterine bleeding aub, a term that refers to menstrual bleeding of abnormal quantity, duration, or schedule, is a common. Dysfunctional uterine bleeding describes the sp ectrum of abnormal bleeding patterns in the abscence of a medical illness or pelvic pathology. Abnormal uterine bleeding is one of the most common reasons for women to seek for care. Change to an alternative progestogen the variability of trial design makes it impossible to definitively rank progestogens as regards general cycle control, although preparations containing gestodene, or norethisterone at a dose of. A classification of abnormal uterine bleeding is presented in table 102.
Menarche occurs from 916 years with an average of 12. Like lots of medical names, it can sound worse than it is. Vaginal bleeding is any bleeding through the vagina, including bleeding from the vaginal wall itself, as well as and more commonly bleeding from another location of the female reproductive system, often the uterus. Dysfunctional uterine bleeding dub represents a particular type of abnormal uterine bleeding aub, and is defined in the usa as an excessive, prolonged and irregular bleeding of the endometrium frequency 7 days. Latest issue common problems in schoolaged children. The causes of abnormal uterine bleeding are varied, depending largely on the age and life stage of the women. Guidelines for the management of heavy menstrual bleeding. We are currently working through back issues of afp for the afp website. Dysfunctional uterine bleeding clinically manifests as menorrhagia or metrorrhagia definition 6. The figo menstrual disorders group, with input from international experts, recommended a simplified description of abnormal bleeding that discarded imprecise terms such as menorrhagia, metrorrhagia, hypermenorrhea, and dysfunctional uterine bleeding dub in favor of plain english descriptions of bleeding that describe the vaginal bleeding in. Selected gynecologic disorders in marx ja, hockberger rs, walls rm, et al eds.
Abnormal uterine bleeding murtaghs general practice, 6e. In cases of acute and severe bleeding, women may need urgent treatment with. Diagnosis of abnormal uterine bleeding in reproductive aged women. Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual. Generally, it is either part of a normal menstrual cycle or is caused by hormonal or other problems of the reproductive system, such as abnormal uterine bleeding. Abnormal uterine bleeding aub merck manuals consumer version. Heavy menstrual bleeding is the commonest cause of irondeficiency anaemia in the western world. The relationship between age and various causes of abnormal uterine bleeding. Managing persistent irregular bleeding in women using cocp.
It is marked by irregular bleeding in amount, duration, and frequency. Management of acute abnormal uterine bleeding in nonpregnant. Evaluation and management of abnormal uterine bleeding in. Download pdf file to read more what is dysfunctional uterine bleeding dub dysfunctional uterine bleeding dub is abnormal bleeding from the uterus that is not due to pregnancy or other recognizable pathology in the womens uterus, pelvic or systemic disease. A variety of things can cause abnormal uterine bleeding. Abnormal uterine bleeding commonly results when the level of estrogen remains high instead of decreasing as it normally does after an egg is released and is not fertilized. In 2011, the figo classification system palmcoein was published to standardize terminology, diagnostic and investigations of causes of abnormal uterine bleeding aub. According to figo new classification, in the absence of structural etiology, the formerly called dysfunctional uterine bleeding should be avoided and clinicians should state if aub are caused by coagulation disorders. Howeve r, there are rare hormonal conditions that cause abnormal uterine bleeding in ovulatory cycles. May 09, 20 dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off.
As a result, in ovulatory dysfunctional uterine bleeding, treatment with prostaglandin synthetase inhibitors are more effective than hormonal treatment. The management of dysfunctional uterine bleeding glowm. Dysfunctional uterine bleeding and uterine fibroids. Dysfunctional uterine bleeding is most commonly associated with chronic anovulation. Approach to abnormal uterine bleeding in nonpregnant reproductive. This can include alternating periods that are heavy and light, spotting or unpredictable shorter and longer. The normal duration of menstrual bleeding is between two and seven days. This type is called abnormal uterine bleeding due to ovulatory dysfunction aubo. 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. This can include alternating periods that are heavy and light, spotting or. A free powerpoint ppt presentation displayed as a flash slide show on id. Vaginal bleeding may be heavy, or last for longer than a week.
The focus in this policy is on treatment options when the bleeding pattern is abnormal. Abnormal uterine bleeding is a common presenting symptom in the family practice setting. Irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. Abnormal uterine bleeding dysfunctional uterine bleeding ncbi. Racgp the management of irregular bleeding in women using. Medical treatments include nonsteroidal antiinflammatory drugs, oral contraceptive pills, progestins, danazol a synthetic androgen. Feb 06, 2020 dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. Dysfunctional uterine bleeding discharge care what you. During reproductive life, the endometrium cycle is controlled by the pituitary and ovarian hormones abnormalities in this system result in uterine bleeding, which can be. Department of obstetrics and gynecology uksmwichita introduction dysfunctional uterine bleeding dub is defined. Treatment options for dysfunctional uterine bleeding. This time usually starts in women in their mid to late forties and may last between one and seven years.
The normal menstrual cycle consists of a proliferative and a nonproliferative stage, separated by the midcyclic point of ovulation. Ppt dysfunctional uterine bleeding powerpoint presentation. Up to onethird of women will experience abnormal uterine bleeding in their life, with irregularities most commonly occurring at menarche and. Definition dysfunctional uterine bleeding is irregular, abnormal uterine bleeding that is not caused by a tumor, infection, or pregnancy. Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. Clinical policy effective11012011 19962012, oxford health plans, llc 3 manual endometrial ablation.
Dysfunctional uterine bleeding is prolonged, excessive or frequent, unpatterned uterine bleeding that is not related to an anatomical uterine abnormality or systemic cause. Abnormal uterine bleeding in young girls bleeding before menarche the first period in a girls life is always abnormal. 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. Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. Abnormal uterine bleeding is a common problem encountered in general practice. The most common type of abnormal bleeding results from changes in the hormonal control of menstruation. Pdf file of the complete article 964k, or click on.
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