Problem bleeding is among the most common gynecologic complaints of reproductive age women in ambulatory care settingsof similar frequency to the number seeking care for urinary tract infections and vaginitis. It may be associated with ovulatory and anovulatory cycles. It is any irregular bleeding that occurs, when there is no presence of any organic medical disease or condition, such as pregnancy. Although many etiologies cause aub, the one most likely cause among adolescents are dysfunctional uterine bleeding dub. Overview of abnormal uterine bleeding in adolescents. It is a diagnosis of exclusion made after structural causes of bleeding and chronic medical diseases have been ruled out. Abnormal uterine bleeding aub describes a range of symptoms, such as heavy menstrual bleeding hmb, bleeding above the 95th centile of the normal population, intermenstrual bleeding and a combination of both heavy and prolonged menstrual bleeding. Premenopausal women with dub may respond to oral contraceptives. Abnormal uterine bleeding aub may be acute or chronic and is defined as. Some of them are not serious and are easy to treat. 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. Figo classification system palmcoein for causes of abnormal. Dysfunctional uterine bleeding dub is defined as excessively heavy, prolonged or frequent bleeding. Know the types, causes, symptoms, treatment and diagnosis of dysfunctional uterine bleeding.
Ashermans syndrome dysfunctional uterine bleeding endometrial hyperplasia endometrial polyp endometriosis endometritis. It is a difficult condition for the woman, mentally as well as socially and also financially. Other causes of abnormal bleeding must also be ruled out, including. Abnormal uterine bleeding occurs when either the frequency or quantity of uterine. Abnormal uterine bleeding is an extremely common indication for referral to a gynaecologist. Abnormal vaginal bleeding in adolescents susan hayden. Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. Bleeding that occurs erratically or excessive regular menstrual bleeding is considered to be abnormal uterine bleeding. Abnormal uterine bleeding is one of the most common reasons for women to seek for care. Abnormal uterine bleeding aub, also known as atypical vaginal bleeding, is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long. 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. Abnormal uterine bleeding is a common presenting symptom in the family practice setting. Abnormal uterine bleeding aub is a frequent cause of visits to health care provider during adolescent period and is characterized by irregular, excessively heavy, prolonged andor frequent bleeding of uterine origin. Abnormal uterine bleeding previously, dysfunctional uterine bleeding dub is irregular uterine bleeding that happens in the absence of recognizable pelvic pathology, basic medical disease, or pregnancy.
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. This article provides nps with a practical overview of the process from chief complaint to followup care. Dysfunctional uterine bleeding dub is abnormal uterine bleeding that is caused by a problem with your hormones. Dysfunctional uterine bleeding is a common problem in women in the 3050 years age group.
Age, marital status, reproductive health history and details of aub were noted. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. Abnormal uterine bleeding is defined as any alteration in the volume, pattern or duration of menstrual blood flow. Any uterine bleeding that is outside of the normal menstrual patterns in terms of the frequency, volume, regularity or duration of bleeding is considered abnormal table 1. Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. The traditional definitions of abnormal menstrual bleeding are. The term dysfunctional uterine bleeding was used when no underlying cause was present. Health care practitioners deal with this problem frequently. Abnormal uterine bleeding can be due to a number of organic and dysfunctional causes. Abnormal uterine bleeding aub is a condition that affects approximately 30% of women during their reproductive years. Bleeding may be heavier or lighter than usual and occur often or randomly. Abnormal uterine bleeding british medical bulletin. The normal cycle is triggered by signals from hormones.
Abnormal uterine bleeding has various definitions and. Aub may be accompanied by pain and discomfort, cause significant social embarrassment, and have a substantial effect on healthrelated quality of life. Abnormal uterine bleeding affects up to 50% of perimenopausal women, and dub in these women is most likely caused by a decline in ovarian function. Abnormal uterine bleeding and uterine fibroids page 2 of 19 unitedhealthcare commercial medical policy effective 04012020 proprietary information of unitedhealthcare. The normal duration of menstrual bleeding is between two and seven days. Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. In the general population, abnormal uterine bleeding is estimated to affect 11 to percent of reproductive age women at any given time.
Dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of pathology or medical illness. 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. Abnormal uterine bleeding aub is a common problem among women in the reproductive age. Clinical practice clinical update dysfunctional uterine. 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. Dysfunctional uterine bleeding dub is often caused by a hormonal imbalance. Formerly, it was known as dysfunctional uterine bleeding dub. Dysfunctional uterine bleeding describes the sp ectrum of abnormal bleeding patterns in the abscence of a medical illness or pelvic pathology. Dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to structural abnormalities of the uterus or the endometrial lining. You may have bleeding from your uterus at times other than your normal monthly period. Abnormal uterine bleeding miscarriage ectopic pregnancy certain types of cancer, such as cancer of the uterus your obstetriciangynecologist obgyn or other health care professional may start by checking for problems most common in your age group.
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. Investigating and managing abnormal vaginal bleeding. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause. Guidelines for the management of abnormal uterine bleeding. Aub is responsible for significant health problem and social embarrassment and. Dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Abnormal uterine bleeding aub is any variance of the normal menstrual cycle, which is defined on the basis of four parameters frequency, regularity, duration, and volume. This chapter examines the modes of presentation and the causes of such symptoms, which range from physiological variations to more sinister underlying pathology. Dysfunctional uterine bleeding what you need to know. Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual. 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 vaginal bleeding in adolescents susan hayden gray, md.
Polyps or fibroids small and large growths in the uterus can also cause bleeding. The medical management of abnormal uterine bleeding in. The pathophysiology is not fully understood and it is complex. The average volume of blood loss is between 3080 ml. Uterine pathology, particularly endometrial carcinoma, is common in postmenopausal women with abnormal uterine bleeding. Dysfunctional uterine bleeding occurs when the normal cycle of menstruation is disrupted, usually due to anovulation failure to ovulate thats unrelated to. Aub leads to loss of productivity1 and may result in surgical interventions including hysterectomy2. Uterine and systemic causes must be excluded before the diagnosis is made. Abnormal uterine bleeding aub is a common and debilitating condition with high direct and indirect costs. Abnormal uterine bleeding is a frequent condition in gynecology. A common and often debilitating condition, affecting women of reproductive age. It is responsible for about half of the women with abnormal uterine bleeding in reproductive age ewenstein, 1996. Perdarahan uterus abnormal dysfunctional uterine bleeding atau dub adalah kondisi yang memengaruhi hampir setiap wanita paling tidak satu kali seumur hidupnya.
Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. Pathophysiology of abnormal uterine bleeding request pdf. Repercussions of abnormal uterine bleeding on different. Abnormal uterine bleeding can be caused by many different conditions. A variety of things can cause abnormal uterine bleeding. Management of abnormal uterine bleeding in reproductive. It reflects an interruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. Aub among nongravid women of reproductive age has been hampered both by confusing and. Dysfunctional uterine bleeding dub is defined as abnormal uterine bleeding that results from an ovarian endocrinopathy. Abnormal uterine bleeding is a common problem,1 and its management can be complex. 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. Abnormal uterine bleeding geneva foundation for medical. The diagnosis of dub depends on a thorough history and physical examination to exclude organic disorders. Dysfunctional uterine bleeding is a diagnosis of exclusion.
In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable. Abnormal uterine bleeding aub is the name currently used for changes in. Prolactin level in women with abnormal uterine bleeding. Discuss the differential diagnosis of abnormal vaginal bleeding in adolescents. Abnormal uterine bleeding formerly, dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. The initial goal in the approach to evaluation of an adolescent with abnormal bleeding is to determine hemodynamic stability, locate the origin of bleeding, identify any organic causes and. Terms such as menorrhagia, metrorrhagia, oligomenorrhea and dysfunctional uterine bleeding are no longer recommended by the international federation of gynecology and obstetrics menstrual disorder. Dysfunctional uterine bleeding dub is a common problem often reported in the emergency department of the hospitals.
The diagnosis and treatment of dysfunctional uterine bleeding can be a long emotional journey for the patient and a difficult challenge for the provider. Management of acute abnormal uterine bleeding in nonpregnant. Abnormal uterine bleeding treatment algorithm bmj best. Once a woman who is not taking hormone therapy enters menopause and the menstrual cycles have ended, any uterine bleeding is considered abnormal. Patients who use and then cease using contraceptives like the combined oral contraceptive pill cocp may experience secondary amenorrhoea as a withdrawal symptom. Dysfunctional uterine bleeding is basically abnormal vaginal bleeding in the reproductive years of a woman. Abnormal uterine bleeding national health portal of india.
The investigation and management of abnormal uterine bleeding. Menurut american society for reproductive medicine, kondisi ini paling umum terjadi saat pubertas dan menopause, tapi bisa dialami kapan saja bila kadar hormon dalam tubuh tidak seimbang. Outline a strategy for diagnosis and management of abnormal vaginal bleeding. In this study, a total of 400 women in the reproductive age group with aub attending gmc hospital were recruited and their prolactin levels were evaluated. Abnormal uterine bleeding american family physician. Abnormal uterine bleeding aub is a broad term that describes irregularities in the menstrual cycle involving frequency, regularity, duration. Abnormal uterine bleeding aub is a common problem among nonpregnant women in the reproductive age. Pdf dysfunctional uterine bleeding dub represents a particular type of abnormal uterine bleeding aub, and is defined in the usa as an excessive. 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. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. Primary care management of abnormal uterine bleeding aub.
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