Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. Aub among nongravid women of reproductive age has been hampered both by confusing and. 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. Primary care management of abnormal uterine bleeding aub. Management of abnormal uterine bleeding in reproductive. Abnormal uterine bleeding aub may be acute or chronic and is defined as. The diagnosis and treatment of dysfunctional uterine bleeding can be a long emotional journey for the patient and a difficult challenge for the provider. Other causes of abnormal bleeding must also be ruled out, including. Abnormal uterine bleeding aub is bleeding from the uterus that is longer than usual or that occurs at an irregular time. Aub is responsible for significant health problem and social embarrassment and. Abnormal uterine bleeding can be due to a number of organic and dysfunctional causes.
The traditional definitions of abnormal menstrual bleeding are. Outline a strategy for diagnosis and management of abnormal vaginal bleeding. Ashermans syndrome dysfunctional uterine bleeding endometrial hyperplasia endometrial polyp endometriosis endometritis. Health care practitioners deal with this problem frequently. Dysfunctional uterine bleeding is basically abnormal vaginal bleeding in the reproductive years of a woman. Abnormal uterine bleeding geneva foundation for medical. Abnormal uterine bleeding aub is a common clinical problem, affecting up to 14% of women during their reproductive years and impairing their quality of life by creating significant physical, emotional, sexual, social, and financial burdens. In this study, a total of 400 women in the reproductive age group with aub attending gmc hospital were recruited and their prolactin levels were evaluated. The investigation and management of abnormal uterine bleeding. Abnormal vaginal bleeding in adolescents susan hayden gray, md. 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 uterine bleeding can be caused by many different conditions.
Polyps or fibroids small and large growths in the uterus can also cause bleeding. Uterine and systemic causes must be excluded before the diagnosis is made. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause. Bleeding that occurs erratically or excessive regular menstrual bleeding is considered to be abnormal uterine bleeding. Dysfunctional uterine bleeding occurs when the normal cycle of menstruation is disrupted, usually due to anovulation failure to ovulate thats unrelated to. A variety of things can cause abnormal uterine bleeding. 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. Patients who use and then cease using contraceptives like the combined oral contraceptive pill cocp may experience secondary amenorrhoea as a withdrawal symptom. A common and often debilitating condition, affecting women of reproductive age. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. Abnormal uterine bleeding aub, also known as atypical vaginal bleeding, is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long.
Abnormal uterine bleeding dysfunctional uterine bleeding ncbi. Dysfunctional uterine bleeding dub is a common problem often reported in the emergency department of the hospitals. Abnormal uterine bleeding affects up to 50% of perimenopausal women, and dub in these women is most likely caused by a decline in ovarian function. In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable. Premenopausal women with dub may respond to oral contraceptives. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. Bleeding may be heavier or lighter than usual and occur often or randomly. Dysfunctional uterine bleeding is a diagnosis of exclusion. Abnormal uterine bleeding miscarriage ectopic pregnancy certain types of cancer, such as cancer of the uterus your obstetriciangynecologist obgyn or other health care professional may start by checking for problems most common in your age group. The normal duration of menstrual bleeding is between two and seven days. Abnormal uterine bleeding is one of the most common reasons for women to seek for care. Any uterine bleeding that is outside of the normal menstrual patterns in terms of the frequency, volume, regularity or duration of bleeding is considered abnormal table 1.
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. The initial goal in the approach to evaluation of an adolescent with abnormal bleeding is to determine hemodynamic stability, locate the origin of bleeding, identify any organic causes and. Dysfunctional uterine bleeding dub is abnormal uterine bleeding that is caused by a problem with your hormones. Dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Dysfunctional uterine bleeding dub is often caused by a hormonal imbalance. Investigating and managing abnormal vaginal bleeding. Abnormal uterine bleeding due to ovulatory dysfunction aubo. Abnormal uterine bleeding is a common problem,1 and its management can be complex.
Abnormal uterine bleeding has various definitions and. Pdf dysfunctional uterine bleeding dub represents a particular type of abnormal uterine bleeding aub, and is defined in the usa as an excessive. It is any irregular bleeding that occurs, when there is no presence of any organic medical disease or condition, such as pregnancy. Abnormal uterine bleeding aub is a broad term that describes irregularities in the menstrual cycle involving frequency, regularity, duration. Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. 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. 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. Abnormal uterine bleeding is a frequent condition in gynecology. Chronic abnormal uterine bleeding aub, a term that refers to menstrual bleeding of abnormal quantity, duration, or schedule, is a common gynecologic problem, occurring in approximately 10 to 35 percent of women.
Age, marital status, reproductive health history and details of aub were noted. This chapter examines the modes of presentation and the causes of such symptoms, which range from physiological variations to more sinister underlying pathology. Chronic heavy or prolonged uterine bleeding can result in anemia, interfere with daily activities, and raise concerns about uterine cancer. Abnormal vaginal bleeding in adolescents susan hayden. Prolactin level in women with abnormal uterine bleeding. This article provides nps with a practical overview of the process from chief complaint to followup care. Terms such as menorrhagia, metrorrhagia, oligomenorrhea and dysfunctional uterine bleeding are no longer recommended by the international federation of gynecology and obstetrics menstrual disorder. Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual. It reflects an interruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining.
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. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. Dysfunctional uterine bleeding dub is defined as abnormal uterine bleeding that results from an ovarian endocrinopathy. Dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of pathology or medical illness. Repercussions of abnormal uterine bleeding on different. Figo classification system palmcoein for causes of abnormal. Aub leads to loss of productivity1 and may result in surgical interventions including hysterectomy2. Dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to structural abnormalities of the uterus or the endometrial lining.
Abnormal uterine bleeding is defined as any alteration in the volume, pattern or duration of menstrual blood flow. Abnormal uterine bleeding treatment algorithm bmj best. 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. Thus, in this age group, endometrial biopsy or transvaginal ultrasonography is included in the initial investigation. The pathophysiology is not fully understood and it is complex. It may be associated with ovulatory and anovulatory cycles.
The management of dysfunctional uterine bleeding glowm. Dysfunctional uterine bleeding describes the sp ectrum of abnormal bleeding patterns in the abscence of a medical illness or pelvic pathology. Abnormal uterine bleeding national health portal of india. Abnormal uterine bleeding aub is a common problem among women in the reproductive age. Dysfunctional uterine bleeding dub is defined as excessively heavy, prolonged or frequent bleeding. Abnormal uterine bleeding british medical bulletin. 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 occurs when either the frequency or quantity of uterine. Pathophysiology of abnormal uterine bleeding request pdf. Abnormal uterine bleeding aub is a common and debilitating condition with high. Guidelines for the management of abnormal uterine bleeding. Abnormal uterine bleeding aub describes a range of symptoms, such as heavy menstrual bleeding hmb, bleeding above the 95th centile of the normal population, intermenstrual bleeding and a combination of both heavy and prolonged menstrual bleeding. Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. Dysfunctional uterine bleeding is a common problem in women in the 3050 years age group. Abnormal uterine bleeding aub is a common problem among nonpregnant women in the reproductive age.
Know the types, causes, symptoms, treatment and diagnosis of dysfunctional uterine bleeding. 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 diagnosis of exclusion made after structural causes of bleeding and chronic medical diseases have been ruled out. Abnormal uterine bleeding is a common presenting symptom in the family practice setting. Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. The diagnosis of dub depends on a thorough history and physical examination to exclude organic disorders. Although many etiologies cause aub, the one most likely cause among adolescents are dysfunctional uterine bleeding dub. Abnormal uterine bleeding aub is a condition that affects approximately 30% of women during their reproductive years.
Abnormal uterine bleeding aub is a frequent cause of visits to health care provider during adolescent period and is characterized by irregular, excessively heavy, prolonged andor frequent bleeding of uterine origin. Some of them are not serious and are easy to treat. Once a woman who is not taking hormone therapy enters menopause and the menstrual cycles have ended, any uterine bleeding is considered abnormal. Perdarahan uterus abnormal dysfunctional uterine bleeding atau dub adalah kondisi yang memengaruhi hampir setiap wanita paling tidak satu kali seumur hidupnya. Treatment options for dysfunctional uterine bleeding. It is a difficult condition for the woman, mentally as well as socially and also financially. Abnormal uterine bleeding and uterine fibroids page 2 of 19 unitedhealthcare commercial medical policy effective 04012020 proprietary information of unitedhealthcare. You may have bleeding from your uterus at times other than your normal monthly period. Management of acute abnormal uterine bleeding in nonpregnant. The average volume of blood loss is between 3080 ml. Overview of abnormal uterine bleeding in adolescents. The medical management of abnormal uterine bleeding in. Formerly, it was known as dysfunctional uterine bleeding dub. The normal cycle is triggered by signals from hormones.
Clinical practice clinical update dysfunctional uterine. Dysfunctional uterine bleeding what you need to know. Menurut american society for reproductive medicine, kondisi ini paling umum terjadi saat pubertas dan menopause, tapi bisa dialami kapan saja bila kadar hormon dalam tubuh tidak seimbang. Discuss the differential diagnosis of abnormal vaginal bleeding in adolescents. The term dysfunctional uterine bleeding was used when no underlying cause was present.
Abnormal uterine bleeding is an extremely common indication for referral to a gynaecologist. Abnormal uterine bleeding aub is the name currently used for changes in. Abnormal uterine bleeding american family physician. Aub may be accompanied by pain and discomfort, cause significant social embarrassment, and have a substantial effect on healthrelated quality of life. In the general population, abnormal uterine bleeding is estimated to affect 11 to percent of reproductive age women at any given time. It is responsible for about half of the women with abnormal uterine bleeding in reproductive age ewenstein, 1996. 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. Its most common during puberty and menopause, but can occur at any time during a womans life. Abnormal uterine bleeding aub is a common and debilitating condition with high direct and indirect costs.
1508 1512 985 1246 1206 397 322 1187 1064 915 506 609 1174 1132 790 131 1506 228 734 582 1093 1156 1276 828 1155 346 453 1464 1330 1381 1063 1169 673 1162 642 751 1506 1023 605 142 1403 552 826 449 404 402 1024 364 721