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 |
| Complications | Iron deficiency anemia |
| Causes | Ovulation problems, fibroids, lining of the uterus growing into the uterine wall, uterine polyps, underlying bleeding problems, side effects from birth control, cancer |
| Diagnostic method | Based on symptoms, blood work, medical imaging, hysteroscopy |
| Differential diagnosis | Ectopic pregnancy |
| Treatment | Hormonal birth control, GnRH agonists, tranexamic acid, NSAIDs, surgery |
| Frequency | Relatively common |
Abnormal uterine bleeding is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long, is heavier than normal, or is irregular. The term "dysfunctional uterine bleeding" was used when no underlying cause was present. Quality of life may be negatively affected.
The underlying causes may be structural or non-structural and are classified in accordance with the FIGO system 1 & 2. 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. 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. The first step in work-up is to rule out a tumor or pregnancy. 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.
Treatment depends on the underlying cause. Options may include hormonal birth control, gonadotropin-releasing hormone agonists, tranexamic acid, nonsteroidal anti-inflammatory drugs, and surgery such as endometrial ablation or hysterectomy. Over the course of a year, roughly 20% of reproductive-aged women self-report at least one symptom of abnormal uterine bleeding.