Bleeding - dysfunctional uterine
Key points
- Dysfunctional uterine bleeding (DUB) is abnormal vaginal bleeding that occurs during a menstrual cycle that produced no egg (ovulation did not take place).
- Anovulatory or dysfunctional uterine bleeding is a diagnosis of exclusion.
- Young women within several years of menarche (the first menstrual period) are not treated unless symptoms are exceptionally severe, such as heavy blood loss causing anemia.
- Hormonal regulation is usually successful in alleviating symptoms.
Alternative names
Anovulatory bleeding; Dysfunctional uterine bleeding; DUB
Definition
Dysfunctional uterine bleeding (DUB) is abnormal vaginal bleeding that occurs during a menstrual cycle that produced no egg (ovulation did not take place).
Causes, incidence, and risk factors
Anovulatory or dysfunctional uterine bleeding is a diagnosis of exclusion. This means that it is determined only AFTER other causes of abnormal uterine bleeding - such as systemic diseases, medications, early pregnancy disorders, eating disorders, gynecological infections, structural anomalies, or tumors - have been ruled out.
Anovulatory cycles are common for the first year after menarche (when a girl begins to menstruate), and later in life as a woman approaches menopause (when menstrual periods stop). Approximately 20% of cases occur in adolescents and 40% in women over 40. Obesity, excessive exercise, and emotional stress may be risk factors for DUB.
Symptoms
- Vaginal bleeding between periods
- Abnormal menstrual periods
- Variable menstrual cycles (usually less than 28 days between menstrual periods)
- Variable menstrual flow ranging from scanty to profuse
- Infertility
- Mood swings
- Hot flashes
- Vaginal tenderness
- Hirsuitism - excessive growth of body hair in a male pattern
Signs and tests
A pelvic examination will be performed.
Tests to evaluate women with DUB usually include:
- CBC
- Serum HCG (to rule out pregnancy)
- Thyroid function tests specific hormonal regulation tests
o Prolactin
o Androgen levels
o FSH (follicle-stimulating hormone)
o LH (luteinizing hormone)
Diagnostic procedures that may be performed include:
- Endometrial biopsy
- D and C (dilatation and curettage)
- Pelvic ultrasound
- Hysteroscopy
Treatment
Young women within several years of menarche (the first menstrual period) are not treated unless symptoms are exceptionally severe, such as heavy blood loss causing anemia.
Frequently asked questions
What is bleeding?
Dysfunctional uterine bleeding (DUB) is abnormal vaginal bleeding that occurs during a menstrual cycle that produced no egg (ovulation did not take place).
What are the risk factors for bleeding?
Anovulatory or dysfunctional uterine bleeding is a diagnosis of exclusion. This means that it is determined only AFTER other causes of abnormal uterine bleeding - such as systemic diseases, medications, early pregnancy disorders, eating disorders, gynecological infections, structural anomalies, or tumors - have been ruled out. Anovulatory cycles are common for the first year after menarche (when a girl begins to menstruate), and later in life as a woman approaches menopause (when menstrual periods stop). Approximately 20% of cases occur in adolescents and 40% in women over 40. Obesity, excessive exercise, and emotional stress may be risk factors for DUB.
What are the symptoms of bleeding?
- Vaginal bleeding between periods
- Abnormal menstrual periods
- Variable menstrual cycles (usually less than 28 days between menstrual periods)
- Variable menstrual flow ranging from scanty to profuse
- Infertility
- Mood swings
- Hot flashes
- Vaginal tenderness
- Hirsuitism - excessive growth of body hair in a male pattern
How is bleeding treated?
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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