Abnormal uterine bleeding
| Abnormal uterine bleeding | |
|---|---|
| Other names | Atypical vaginal bleeding, dysfunctional uterine bleeding (DUB), abnormal vaginal bleeding |
| Specialty | Gynecology |
| Symptoms | Irregular, abnormally frequent, prolonged, or excessive amounts of uterine bleeding[1] |
| Complications | Iron deficiency anemia[2] |
| Causes | Ovulation problems, fibroids, lining of the uterus growing into the uterine wall, uterine polyps, underlying bleeding problems, side effects from birth control, cancer[3] |
| Diagnostic method | Based on symptoms, blood work, medical imaging, hysteroscopy[2] |
| Differential diagnosis | Ectopic pregnancy[4] |
| Treatment | Hormonal birth control, GnRH agonists, tranexamic acid, NSAIDs, surgery[1][5] |
| Frequency | Relatively common[2] |
Abnormal uterine bleeding is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long, is heavier than normal, or is irregular.[1][3] The term "dysfunctional uterine bleeding" was used when no underlying cause was present.[3] Quality of life may be negatively affected.[2]
The underlying causes may be structural or non-structural and are classified in accordance with the FIGO system 1 & 2.[3][6] Common causes include: Ovulation problems, fibroids, the lining of the uterus growing into the uterine wall, uterine polyps, underlying bleeding problems, side effects from birth control, or cancer.[3] Susceptibility to each cause is often dependent on an individual's stage in life (prepubescent, premenopausal, postmenopausal). More than one category of causes may apply in an individual case.[3] The first step in work-up is to rule out a tumor or pregnancy.[3][5] Vaginal bleeding during pregnancy may be abnormal in certain circumstances. Please see Obstetrical bleeding and early pregnancy bleeding for more information.Medical imaging or hysteroscopy may help with the diagnosis.[2]
Treatment depends on the underlying cause.[3][2] Options may include hormonal birth control, gonadotropin-releasing hormone agonists, tranexamic acid, nonsteroidal anti-inflammatory drugs, and surgery such as endometrial ablation or hysterectomy.[1][5] Over the course of a year, roughly 20% of reproductive-aged women self-report at least one symptom of abnormal uterine bleeding.[2]
- ^ a b c d "Abnormal Uterine Bleeding". American College of Obstetrics and Gynecology (ACOG). March 2017. Retrieved 11 September 2018.
- ^ a b c d e f g Whitaker L, Critchley HO (July 2016). "Abnormal uterine bleeding". Best Practice & Research. Clinical Obstetrics & Gynaecology. 34: 54–65. doi:10.1016/j.bpobgyn.2015.11.012. PMC 4970656. PMID 26803558.
- ^ a b c d e f g h Bacon JL (June 2017). "Abnormal Uterine Bleeding: Current Classification and Clinical Management". Obstetrics and Gynecology Clinics of North America. 44 (2): 179–193. doi:10.1016/j.ogc.2017.02.012. PMID 28499529.
- ^ "Vaginal Bleeding". Merck Manuals Professional Edition. Retrieved 11 September 2018.
- ^ a b c Cheong Y, Cameron IT, Critchley HO (September 2017). "Abnormal uterine bleeding". British Medical Bulletin. 123 (1): 103–114. doi:10.1093/bmb/ldx027. PMID 28910998.
- ^ Jain V, Munro MG, Critchley HO (August 2023). "Contemporary evaluation of women and girls with abnormal uterine bleeding: FIGO Systems 1 and 2". International Journal of Gynaecology and Obstetrics. 162 Suppl 2 (Suppl 2): 29–42. doi:10.1002/ijgo.14946. PMC 10952771. PMID 37538019.