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Dysfunctional Uterine Bleeding

more about Dysfunctional Uterine Bleeding

  • This refers to uterine bleeding other than the normal menstrual period.
  • D.U.B is unpredictable according to amount, onset, and duration; usually the bleeding is painless.
  • It usually occurs in early menarche (in the early years after a woman first starts having periods) and in perimenopausal women.
  • It is usually caused by inner uterus (endometrium) overgrowth, due to an over production of estrogen in relation to progesterone.

  • Vaginal bleeding between menstrual periods

  • Often unknown
  • Myomas (i.e., benign tumors)
  • Endometritis
  • Miscarriage
  • Endometrial cancer
  • Ovarian cancer
  • Some birth control pills
  • Stress
  • Current illnesses

  • Made by history
  • Tests:
    1. Complete blood count
    2. Sedimentation rate
    3. Pregnancy test
    4. Glucose level to rule out diabetes
    5. PAP smear
    6. Gynecologic cultures
  • Imaging/procedures that may be considered:
    1. Pelvic ultrasound
    2. Hystero-salpingography (special imaging test of uterus and ovaries)
    3. MRI
    4. Hysteroscope (scope passed in through the cervix into the uterus)
    5. D & C (dilation and curettage) with cervical or endometrial biopsies if they are needed(biopsy of the inner lining of the uterus)

  • Treat underlying cause if found
  • Medications
    1. Progesterone given last 10-14 days of cycle
    2. Birth control pills in order to stop the bleeding
    3. Danazol -- severe cases
    4. Depo-leuprolide -- severe cases
    5. Nafarelin -- severe cases
    6. Intravenous conjugated estrogens -- severe cases
  • Surgical: Endometrial ablation -- bleeding areas are treated with laser or electrical probes.

more about Dysfunctional Uterine Bleeding

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