Abnormal uterine bleeding national health portal of india. The purpose of this guideline is to advise on the management of heavy menstrual bleeding. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. This has been highlighted in the rcog guidelines with an exception of. Michael evans developed the onepager concept to provide clinicians with useful clinical information on primary care topics. Formerly, it was known as dysfunctional uterine bleeding dub. Although dysfunctional uterine bleeding, which is due to immaturity of the hypothalamicpituitaryovarian axis, may be the explanation for many of these issues, it is important to consider other. Guidelines for the management of abnormal uterine bleeding.
Abnormal uterine bleeding is a frequent condition in gynecology. Dysfunctional uterine bleeding dub is the diagnosis given to women with abnormal uterine bleeding in whom no clear etiology can be identified. Howeve r, there are rare hormonal conditions that cause abnormal uterine bleeding in ovulatory cycles. 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 american family physician. Abnormal uterine bleeding due to ovulatory dysfunction aubo. You may have bleeding from your uterus at times other than your normal monthly period. Vaginal bleeding may be heavy, or last for longer than a week. May 09, 20 dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. 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 aub is a common and debilitating condition with high direct and indirect costs. Abnormal uterine bleeding in patient having thyroid. Get a printable copy pdf file of the complete article 651k, or click on a page.
Dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual. Abnormal uterine bleeding has various definitions and. This can include alternating periods that are heavy and light, spotting or unpredictable shorter and longer. Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. Evaluation and management of adolescents with abnormal. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. Description dysfunctional uterine bleeding dub is a disorder that occurs most frequently in women at the beginning and end of their reproductive lives. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Terms used to describe patterns of abnormal uterine bleeding are based on periodicity and. As a result, in ovulatory dysfunctional uterine bleeding, treatment with prostaglandin synthetase inhibitors are more effective than hormonal treatment. Dysfunctional uterine bleeding dub, the most common cause of abnormal uterine bleeding, occurs most often in women 45 50% of cases and in adolescents 20% of cases. Once a woman who is not taking hormone therapy enters menopause and the menstrual cycles have ended, any uterine bleeding is considered abnormal. This time usually starts in women in their mid to late forties and may last between one and seven years. The pathophysiology is not fully understood and it is complex. Dysfunctional uterine bleeding dub is abnormal uterine bleeding that is caused by a problem with your hormones. Signs of hypothyroidism are irregu lar periods with weight gain, lethargy, obstipation, hair loss especially at the eyebrows and a dry skin. Abnormal uterine bleeding aub is a common problem among nonpregnant women in the reproductive age. Aub frequently coexists with fibroids, but the relationship between the two remains.
Other causes of abnormal bleeding must also be ruled out, including. 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. Abnormal uterine bleeding aub is a broad term that describes irregularities in the menstrual cycle involving frequency, regularity, duration. Dysfunctional uterine bleeding dub 2 3 exams and tests dysfunctional uterine bleeding dub is diagnosed after all other causes of abnormal uterine bleeding are ruled out. Abnormal uterine bleeding aub is bleeding from the uterus that is longer than usual or that occurs at an irregular time. Abnormal uterine bleeding can be caused by many different conditions.
Dysfunctional uterine bleeding what you need to know. This revision is part of the series, guidelines and recommendations. Abnormal uterine bleeding aub is a common and debilitating condition with high. Management of acute abnormal uterine bleeding in nonpregnant. Abnormal uterine bleeding aub, also known as atypical vaginal bleeding, is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long, is heavier than normal, or is irregular. Dysfunctional uterine bleeding dub is irregular vaginal bleeding caused by changes in hormone levels. The brody school of medicine at east carolina university. Polyps or fibroids small and large growths in the uterus can also cause bleeding.
Abnormal uterine bleeding aub is a condition that affects approximately 30% of women during their reproductive years. Approach to abnormal uterine bleeding in nonpregnant reproductive. A large number of synonyms and overlapping terms for heavy menstrual bleeding have been identified, as well as smaller numbers of terms for other symptoms and causes of abnormal uterine bleeding. Figo classification system palmcoein for causes of. Clinical policy effective11012011 19962012, oxford health plans, llc 1 clinical policy dysfunctional uterine bleeding and uterine fibroids the services described in oxford policies are subject to the terms, conditions and limitations of the members contract or certificate. Abnormal uterine bleeding and uterine fibroids page 2 of 19 unitedhealthcare community plan medical policy effective 04012020 proprietary information of unitedhealthcare. Abnormal uterine bleeding is a common reason for women of all ages to consult their family physicians. Clinical practice clinical update dysfunctional uterine. A systematic approach to aub evaluation can simplify management and enhance womens wellbeing. In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable. Abnormal uterine bleeding aub is a common condition that leads to increased health care costs and decreased quality of life.
Figo classification system figo international federation of. 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. Abnormal uterine bleeding is a broad term that indicates a change in frequency of menses, duration of flow or amount of blood loss. This guideline will not address postmenopausal bleeding or other. Abnormal uterine bleeding in the premenopausal period 93 hypothyroidism, hyperthyroidism and hyperprolactinemia. Abnormal uterine bleeding dysfunctional uterine bleeding ncbi. Figo classification system palmcoein for causes of abnormal. Episode of heavy bleeding requires immediate medical evaluation. In cases of acute and severe bleeding, women may need urgent treatment with.
The term dysfunctional uterine bleeding was used when no underlying cause was present. Abnormal uterine bleeding is a common, debilitating condition. Dysfunctional uterine bleeding yakima womens health pllc. The investigation and management of menorrhagia hse. Menstrual blood loss can be assessed simply, objectively and reproducibly with pictographs or a bleeding score. This can include alternating periods that are heavy and light, spotting or. Dysfunctional uterine bleeding definition of dysfunctional. Change in amount and frequency of bleeding, associated with anovulatory bleeding.
These complaints may significantly affect quality of life, result in time off work 14, lead to surgical interventions including hysterectomy 15, and ultimately have a significant. When this happens, your periods may come less than 21 days apart, or more than 35 days apart. Dysfunctional uterine bleeding dub represents a particular type of abnormal uterine bleeding aub, and is defined in the usa as an excessive, prolonged and irregular bleeding of the endometrium. It is a diagnosis of exclusion made after structural causes of bleeding and chronic medical diseases have been ruled out. The investigation and management of abnormal uterine bleeding.
Evaluation and management of abnormal uterine bleeding in. Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. Health care practitioners deal with this problem frequently. A variety of things can cause abnormal uterine bleeding. Abnormal uterine bleeding between menarche and menopause do history and physical exam. National collaborating centre for womens and childrens health, national institute of clinical excellence. Bleeding may be heavier or lighter than usual and occur often or randomly. Abnormal uterine bleeding due to ovulatory dysfunction aubo is abnormal uterine bleeding that, after examination and ultrasonography, cannot be attributed to the usual causes structural gynecologic abnormalities, cancer, inflammation, systemic disorders, pregnancy, complications of pregnancy, use of oral contraceptives or certain drugs. This chapter specifically addresses uterine bleeding resulting from alterations in the normal cyclical changes of the endometrium. Dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to structural abnormalities of the uterus or the endometrial lining.
Dysfunctional uterine bleeding is a common problem in women in the 3050 years age group. Definition dysfunctional uterine bleeding is irregular, abnormal uterine bleeding that is not caused by a tumor, infection, or pregnancy. Treatment options for dysfunctional uterine bleeding. Dub has been observed in both ovulatory and anovulatory cycles. This guideline will not address postmenopausal bleeding or other unscheduled bleeding such as intermenstrual or postcoital bleeding. Dysfunctional uterine bleeding by, nazni nazar 2009 mbbs 2. Feb 03, 2020 what is dysfunctional uterine bleeding. Abnormal uterine bleeding is a common but complicated clinical presentation, accounting for at least 20% of all new outpatient visits 12.
Bleeding that occurs erratically or excessive regular menstrual bleeding is considered to be abnormal uterine bleeding. The medical management of abnormal uterine bleeding in. The recommendations in this guideline represent the view of nice, arrived at after careful consideration of the evidence available. Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. This type of bleeding is commonly referred to as dysfunctional uterine bleeding dub. Abnormal uterine bleeding the menstrual bleed that is abnormally heavy or abnormal in timing assessment causes 1. Uterine and systemic causes must be excluded before the diagnosis is made.
Dysfunctional uterine bleeding and uterine fibroids. Clinical practice guidelines management of abnormal uterine. The diagnosis and treatment of dysfunctional uterine bleeding can be a long emotional journey for the patient and a difficult challenge for the provider. Early pregnancy disorders infection structure problems tumors the health care provider will do a pelvic examination. These guidelines were adapted from other international guidelines on management of menorrhagia or heavy menstrual bleeding and modified to suit the local. Iucd related irregularity diagnosis is made by excluding organic cause. Abnormal uterine bleeding and uterine fibroids community. Its most common during puberty and menopause, but can occur at any time during a womans life.
Abnormal uterine bleeding in the premenopausal period. Evaluation and management of abnormal uterine bleeding. Abnormal uterine bleeding describes any variation from normal. Feb 06, 2020 dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. Dysfunctional uterine bleeding is a diagnosis of exclusion.
Dysfunctional uterine bleeding is most commonly associated with chronic. Aub is responsible for significant health problem and social embarrassment and it is one of the common reasons women seek health care. Abnormal uterine bleeding david g weismiller, md, scm, faafp department of family medicine. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause. Jun 12, 2017 dysfunctional uterine bleeding dub represents a particular type of abnormal uterine bleeding aub, and is defined in the usa as an excessive, prolonged and irregular bleeding of the endometrium frequency 7 days. 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. Severe acute bleeding irregular bleeding menorrhagia secondary amenorrhea pregnant figure 3 figure 4 figure 5 figure 6 figure 2 any abnormal pattern associated with certain. 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. Signs of hyperthyroidism are sweating, menorrhagia, palpitations, weight loss. 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. This article provides nps with a practical overview of the process from chief complaint to followup care.
The international federation of gynecology and obstetrics and the american congress of obstetricians and gynecologists support the use of new terminology for abnormal uterine bleeding. Abnormal uterine bleeding is a common presenting symptom in the family practice setting. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding dub is often caused by a hormonal imbalance. Perimenopausal dysfunctional uterine bleeding the perimenopause is the time prior to the natural cessation of menses when many changes occur due to the absence of ovulation and decreased estrogen production.
880 215 603 661 1533 401 999 1266 985 206 1092 625 780 500 336 1130 1504 1225 790 1337 698 728 98 1383 37 1350 1364 1490 1495 1197 1492 495 1144 231 565