Everyone Healthy Library
Dysfunctional Uterine Bleeding
Condition / disease reference page from the Everyone Healthy database.
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Condition overview
Attributes
Genderis F
Linked signs and symptoms
3Each sign/symptom opens its own page and links back to related conditions.
Linked drugs / medications
6Medication information is educational only. A doctor or pharmacist should advise whether any medicine is appropriate.
Treatments, therapies and supportive options
5Grouped by treatment type. These are educational database links, not personal treatment recommendations. Evidence labels are shown only where stored in the EH database.
Medical therapy
1Lifestyle changes
2Vitamins and minerals
1Linked diagnostic tests and investigations
5These are pulled from both EH diagnostic-test link tables, including the older large test-link table.
Biological and test markers
5This visual map uses existing EH database links to show biological agents and lab markers reported as increased, decreased, or associated with this condition. These are educational relationships only; test results must be interpreted by a qualified clinician because ranges vary by lab, method, age, sex and clinical context.
Often increased
2- Plasma thromboplastin antecedentReference range exampleAdult ( > 16y): 20–35 secondsLinked diagnostic tests1Activated Partial Thromboplastin Time (APTT)
- Uric Acid, BloodReference range exampleAdult ( > 16y), Female: 2.5–7 mg/dL; Adult ( > 16y), Male: 4–8 mg/dLLinked diagnostic tests1Blood Uric Acid Concentration Test
Often decreased
3- Hemoglobin (Hb)
- IronReference range exampleChild (0 - 16y): 50–120 µg/dL; Adult ( > 16y), Female: 50–150 µg/dLLinked diagnostic tests2Iron Concentration, Total Iron Binding Capacity (TIBC)
- UrineReference range exampleAdult ( > 16y): 4.5–7.5; Child (0 - 16y): 500–1,400 mLLinked diagnostic tests5Urine Colour, Urine Creatinine Concentration
Other associated markers
0No markers in this group.
Introduction / full article
Dysfunctional Uterine Bleeding
Dysfunctional Uterine Bleeding
Dysfunctional Uterine Bleeding (DUB) is an abnormal uterine bleeding which is associated with hormone level changes but is not be related to any pathology or disease condition. [1] Most patients are managed using medications while some may undergo surgical procedures as part of treatment. [2]
Epidemiology
DUB is a frequent condition especially in the outpatient setting. Most patients belong to the adolescent group and perimenopausal group. [1]
Causes
DUB is largely classified into two types namely anovulatory and ovulatory. In the first type, there is unsuccessful cyclical secretion of progesterone leading to unrestricted estradiol. The upshot is overgrowth of the endometrium resulting to necrosis and irregular bleeding. The second type is less frequent and is theorized to be brought about by a defect in local endometrial hemostasis. Factors that may increase the chance of an individual to have the condition include adolescence or perimenopause, obesity, cigarette smoking and having conditions like polycystic ovarian syndrome. [3]
Signs and Symptoms
Patients usually experience bleeding in between periods. The periods do not fall within the normal time frame which is less than 28 days apart or more than 35 days part. The timing between periods may seem to vary every month and the menstruation is heavier as the sanitary napkin becomes more soaked than usual and large clots are passed. Also, the duration is menstruation is longer than normal (greater than seven days). Some patients may have hot flashes, mood disturbances and excessive body hair. [4]
Diagnosis
After getting the patient’s history, pelvic examination is typically performed. Some may do Pap smear. Among the laboratory exams that may be requested include pregnancy test, complete blood count, blood clotting profile, hormone level tests, transvaginal ultrasound and thyroid function test.[4]
Treatment
The objective is to manage the menstrual cycle. The physician may prescribe contraceptive pills. In some instances, intrauterine device is recommended. Patients who have anemia may be given iron supplements. When the case is severe and the patient is not looking forward to have children, surgical procedure like hysterectomy may be an option. [4]
References:
- http://emedicine.medscape.com/article/257007-overview#a0101
- https://www.clinicalkey.com/topics/obstetrics-gynecology/dysfunctional-uterine-bleeding.html
- https://www.clinicalkey.com/topics/obstetrics-gynecology/dysfunctional-uterine-bleeding.html
- http://www.nlm.nih.gov/medlineplus/ency/article/000903.htm
Efficacy of Alternative and Other Treatments According to GRADE* Ranking:
Ferrous Sulfate (Iron Supplement) [1, 2, 3]:
Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.
Recommendation: Strongly in favor (Iron supplements are recommended to take to avoid anaemia)
Grade of Evidence: Moderate quality of evidence
* www.gradeworkinggroup.org
Summary References
Treatments:
1. http://emedicine.medscape.com/article/953078-treatment
2. https://www.nlm.nih.gov/medlineplus/ency/article/000903.htm
3. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Menstruation_abnormal_bleeding