With significant blood loss, you may experience shortness of breath andor heart palpitations, fainting, or chest pain as your body tries to compensate for your anemia. The high estrogen level is not balanced by an appropriate level of progesterone. This is the most common reason women visit the gynecologist and the second most common reason for a hysterectomy. Abnormal uterine womb bleeding is a common problem in women. Describe the components of the leiomyoma subclassification system for causes of abnormal uterine bleeding in nongravid women of reproductive age. In the treatment of women with abnormal uterine bleeding, once a thorough history, physical examination, and indicated imaging studies are performed and all significant structural causes are excluded, medical management is the firstline approach. Abnormal uterine bleeding aub in nonpregnant reproductiveage women is a common gynecologic symptom. Abnormal uterine bleeding aub is a common problem among women in the reproductive age.
Transvaginal, abnormal uterine bleeding, menorrhagia, proliferative endometrium. Cavernous hemangiomas of the uterus are extremely rare, benign lesions. Sep 09, 2015 the association of professors of gynecology and obstetrics apgo medical student educational objectives define a central body of womens health knowledge, skills and attitudes that are. Jul 16, 20 abnormal uterine bleeding organic causes functional uterine bleedingdub deseases of genitaltract pregnancy related irregularity abnormal bleeding from genitaltract without any demonstrable organic cause. The various conditions responsible for abnormal uterine bleeding in this study were 34 cases of estrogen dominance, 10 cases of abnormal secretory phase, 6 cases of anovulatory endometrium, 6 cases of pilleffect endometrium, 3 cases of simple cystic hyperplasia, 3 cases of chronic endometritis, 2. Avb can be categorised as excessive menstrual bleeding, irregular bleeding and intermenstrual including postcoital bleeding.
Modern management of abnormal uterine bleeding crc press book. In postmenopausal women, abnormal uterine bleeding includes vaginal bleeding 12 months or more. When the bleeding is due to dysfunctional uterine bleeding. We focused on interventions that are suitable for use in primary care practice including medical, behavioral, and complementary and alternative medicine approaches. Abnormal uterine bleeding multiple choice questions for vol. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. Uterine bleeding after the establishment of the menopause is due most often to. It is responsible for more than 20% of all visits to outpatients.
Evaluation and management of abnormal uterine bleeding in. Modern management of abnormal uterine bleeding crc press. Abnormal uterine bleeding is one of the most common reasons for women to seek for care. May 17, 2010 cavernous hemangiomas of the uterus are extremely rare, benign lesions. It can occur at any time during your monthly cycle, including during your normal menstrual period. Abnormal uterine bleeding alberta college of family. In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable.
Miscarriage ectopic pregnancy adenomyosis use of some birth control methods, such as an intrauterine device iud or birth control pills infection of the uterus or cervix fibroids problems with blood clotting. Abnormal uterine bleeding in the premenopausal period. List of abnormal uterine bleeding medications 70 compared. This was a retrospective study on insufficient endometrial biopsies performed for the investigation of premenopausal abnormal uterine bleeding in pok oi hospital, hong kong, from 1 january 2009 to 31 december 2011. Apr 29, 2017 dysfunctional uterine bleeding dub a state of abnormal uterine bleeding aub without any clinically detectable organic, systemic, and iatrogenic cause. Et iol gy of abnormal ute ri ne bl ee din g aetiology of abnormal uterine bleeding general causes local causes dysfunctional 1. In such cases, no egg is released, and the lining of the uterus endometrium may continue to thicken instead of breaking down. Abnormal uterine bleeding aub merck manuals consumer version. Abnormal uterine bleeding is defined as bleeding that occurs at unexpected times, lasting longer or shorter and varies from a typical menstrual cycle.
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. Abnormal uterine bleeding in premenopausal women replaces no. This type is called abnormal uterine bleeding due to ovulatory dysfunction aubo. Funding and disclosures presented at the annual meeting of the massachusetts medical society, worcester. Types of abnormal uterine bleeding different kinds of. Abnormal uterine bleeding aub is a common complaint that affects large numbers of women from puberty to menopause. Dysfunctional uterine bleeding dub a state of abnormal uterine bleeding aub without any clinically detectable organic, systemic, and iatrogenic cause.
Abnormal uterine bleeding aub is a very frequent symptom in women. 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 complaint. It is responsible for about half of the women with abnormal uterine bleeding in reproductive age ewenstein, 1996. Abnormal uterine bleeding can occur as either a change in your normal menstrual period or as bleeding in between your normal menses. Management of abnormal uterine bleeding in reproductive period. What imaging should be performed for a patient with suspected pud. These women may have too much estrogen or not enough progesterone. A rare case of abnormal uterine bleeding caused by cavernous.
Abnormal uterine bleeding is a common presenting symptom in the family practice setting. In women of childbearing age, a methodical history, physical examination, and. Aub leads to loss of productivity1 and may result in surgical interventions including hysterectomy2. This bleeding occurs for many women who have sexual intercourse for the. Vaginal bleeding between periods is one symptom of abnormal uterine bleeding.
Investigation of premenopausal abnormal uterine bleeding. Chronic heavy or prolonged uterine bleeding can result in anemia, interfere with daily activities, and raise concerns about uterine cancer. Abnormal uterine bleeding aub is a significant clinical entity. Identify urgent or emergent conditions that manifest as ab normal bleeding, such as ectopic pregnancy, placenta or vasa previa, and preterm labor. A menstrual abnormality is the cause of discomfort, inconvenience and disruption of healthy, social and. Management of abnormal uterine bleeding jody steinauer, md, mas dept. A population study carried out in dutch general practices revealed an incidence of menorrhagia of 8 per. Definition dysfunctional uterine bleeding is irregular, abnormal uterine bleeding that is not caused by a tumor, infection, or pregnancy. The medical management of abnormal uterine bleeding in reproductiveaged women.
Abnormal vaginal bleeding avb is a frequent reason for women of reproductive age to consult a general practitioner gp. Determining the acuity of the bleeding, the patients medical history, assessing risk factors, and. The most common type of abnormal bleeding results from changes in the hormonal control of menstruation. The prevalence of aub is estimated at 12% in the general population and increases with age, reaching 24% in those aged 3640 years. Abnormal uterine bleeding is a common problem,1 and its management can be complex. 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. Figo classification system palmcoein for causes of. The medical management of abnormal uterine bleeding in. Anemia caused by chronic blood loss makes you tired and weak. A rare case of abnormal uterine bleeding caused by. Health care practitioners deal with this problem frequently. This is the most common clinical presentation of aub. Abnormal uterine bleeding is any heavy or unusual bleeding from the uterus through your vagina. In the uk, over 800,000 women seek help for aub annually.
Abnormal uterine bleeding aub is a condition that affects approximately 30% of women during their reproductive years. Having extremely heavy bleeding during your period can also be. Abnormal uterine bleeding that is heavy andor frequent can also cause you to become anemic. Aub frequently coexists with fibroids, but the relationship between the two remains. Most common cause of abnormal uterine bleeding we found is dub i. Description dysfunctional uterine bleeding dub is a disorder that occurs most frequently in women at the beginning and end of their reproductive lives. Uterine cancer can be one of the biggest causes of heavy uterine bleeding. Dysfunctional uterine bleeding dub without anatomic abnormalities bleeding with a systemic illness iatrogenic bleeding. Guidelines for the management of abnormal uterine bleeding. Abnormal uterine bleeding aub womens health issues. Abnormal uterine bleeding organic causes functional uterine bleedingdub deseases of genitaltract pregnancy related irregularity abnormal bleeding from genitaltract without any demonstrable organic cause. 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. Dysfunctional uterine bleeding and uterine fibroids.
Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. Hkcog guidelines number 5 may 2001 1 hkcog guidelines guidelines on investigation of women with abnormal uterine bleeding under the age of 40 published by the hong kong college of obstetricians and gynaecologists a foundation college of hong kong academy of medicine number 5 may 2001 1 introduction abnormal uterine bleeding aub is a. Cancer of the uterus and infection of the cervix are other causes of bleeding. Polyps or fibroids small and large growths in the uterus can also cause bleeding. Abnormal uterine bleeding abnormal uterine bleeding is defined as bleeding that occurs at unexpected times, lasting longer or shorter and varies from a typical menstrual cycle. Abnormal uterine bleeding commonly results when the level of estrogen remains high instead of decreasing as it normally does after an egg is released and is not fertilized. Research paper transvaginal ultrasound for endometrial.
Primary care management of abnormal uterine bleeding. 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. Us of abnormal uterine bleeding rsna publications online. In cases of acute and severe bleeding, women may need urgent treatment with. Disturbances of heaviness of flow heavy menstrual bleeding hmb. Abnormal uterine bleeding multiple choice questions for. Abnormal uterine bleeding is bleeding from the vagina that occurs frequently or irregularly or lasts longer or is heavier than normal menstrual periods. Ovulatory abnormal uterine bleeding, or menorrhagia, presents as bleeding that occurs at normal, regular intervals but that is excessive in volume or duration. Patients may see a health care provider because of infrequent menses, prolonged and heavy menses menorrhagia, intermenstrual bleeding or spotting, postcoital spotting, or irregular and heavy menses menometrorrhagia. List common manifestations of abnormal bleeding that are speci.
Abnormal uterine bleeding aub is a diagnosis made by a careful process of exclusion which need history, clinical and speculum examination, ultrasound scanning, hysteroscopy endometrial biopsy and laparoscopy. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause. In postmenopausal women, abnormal uterine bleeding includes vaginal bleeding six months or more after the cessation of menses, or unpredictable bleeding in. Abnormal uterine bleeding in women of childbearing age is defined as any change in menstrual period frequency or duration, a change in amount of flow, or any bleeding between cycles. This can be confirmed by your doctor after getting an internal biopsy done which will test the presence of abnormal growths or tumours inside the uterine cavity. A menstrual abnormality is the cause of discomfort, inconvenience and disruption of healthy, social and physical life styles among women worldwide. The prevalence of abnormal uterine bleeding seen in literature is 11% our prevalence of abnormal uterine bleeding is found to be 4. In many women, a hormone imbalance causes bleeding. Chronic heavy or prolonged uterine bleeding can result in anemia, interfere with daily activities, and raise concerns about uterine. Modern management of abnormal uterine bleeding focuses on helping gynecologists refine their operative techniques and consider new approaches to the diagnosis, and treatment, of this highly challenging condition by investigating. Iucd related irregularity diagnosis is made by excluding organic cause. Management of acute abnormal uterine bleeding in nonpregnant women. Aub may be accompanied by pain and discomfort, cause significant social embarrassment, and have a substantial effect on healthrelated quality of life. The following statements isare true regarding the diagnosis of.
Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. A survey of the current literature identified fewer than 50 cases of hemangioma of the uterus. New classification system categorizes causes of abnormal. Lesser percentage we might got because we have calculated prevalence from all women including both obstetrics and gynecology cases.
Patients with chronic aub have abnormal volume, duration, andor frequency of uterine bleeding for at least 6 months and can safely be evaluated on an outpatient basis. 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. Dub is defined as abnormal uterine bleeding with no demonstrable organic cause. Aub and its sub group, heavy menstrual bleeding hmb, are common conditions affecting 1425% of women of reproductive age, and may have a significant impact on their physical, social, emotional and material quality of life. Disclosures as an organization accredited by the accme, medscape, llc, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial. Summary modern management of abnormal uterine bleeding focuses on helping gynecologists refine their operative techniques and consider new approaches to the diagnosis, and treatment, of this highly challenging condition by investigating. Abnormal uterine bleeding aub is a common and debilitating condition with high direct and indirect costs. Dysfunctional uterine bleeding describes the sp ectrum of abnormal bleeding patterns in the abscence of a medical illness or pelvic pathology. It negatively affects health by causing anemia, and impacts the quality of life. Abnormal uterine bleeding aub is a common problem for which pelvic sonography is indicated. Over the history of medicine, there has been a wide range of poorly defined terminology used to describe aub symptoms and etiologies.
Abnormal vaginal bleeding in women of reproductive age. The association of professors of gynecology and obstetrics apgo medical student educational objectives define a central body of womens health knowledge, skills and attitudes that are. The questions too much abnormal uterine bleeding differential and approach to work. When it is a single episode of irregular blood loss in nonpregnant women, it.