Dysfunctional Uterine Bleeding

Dysfunctional Uterine Bleeding or [DUB] is the most common cause of abnormal vaginal bleeding for women.

It is considered an abnormal genital tract bleeding and is based in the uterus and is when there is an absence of structural or organic pathology.

Normal bleeding is menstruation that is seen for approximately 2-7 days – the cycle between menstruation is every 21-35 days.

Hormones involved in Dysfunctional Uterine bleeding including: Estrogen and Progesterone.  There are several types of bleeding dysfunction.

An Important Question to Ask Yourself

Is the bleeding coming from the Vagina or Rectum or Urethra (Urine opening)?

–  For Uterine bleeding – it must be coming from the Vaginal opening. Sometimes this can be confusing to know – especially if it is happening between your menstrual periods.

DUB is Classified into two types:

1.)  Ovulatory
2.)  Anovulatory

Ovulatory

–  This is the process during which an ova is produced and discharge eggs from the ovary.  (Not during your menstrual period)

–  10% of cases are ovulation

–  Abnormal bleeding occurs in relation to ovulation

–  This type of bleeding may point to an endocrine involvement

–  Bleeding may occur mid or late cycle

Anovulatory

–  This is the process of the normal menstrual period (Often your menstrual period is more severe than it was or should be)

–  90% of cases are anovulatory

–  Abnormal bleeding without involvement to ovulation

–  The cause is often associated with rapid weight loss or weight gain, stress, exercise, drugs, or others.

–  Overall endocrine involvement relates to several hormones.

Additional Testing

Often additional testing is required, to ensure diagnosis, and rule out anything else. This may include the following:

1.)  Abdominal X-ray

2.)  Pelvic Ultrasound

3.)  Abdominal Ultrasound

4.)  Blood work

5.)  MRI or CT as needed

Treatment

1.)  Hormone therapy – high dose of Estrogen and Progesterone

2.)  It is important to understand that first-line treatment is Progesterone.

3.)  Iron replacement for anemia

4.)  Hysterectomy is done in some cases

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