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Dysfunctional Uterine Bleeding

Dysfunctional Uterine Bleeding is a topic covered in the 5-Minute Emergency Consult.

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  • Abnormal uterine bleeding is an alteration in pattern or volume of normal menses
    • Typical blood loss during a normal menstrual cycle is 30–80 mL
    • Normal interval between menses 28 (+/− 7) days
  • 2 classifications
    • Dysfunctional uterine bleeding (DUB)
      • Hormonally related
      • Anovulatory and ovulatory categories
      • Not due to organic or iatrogenic causes
      • Diagnosis of exclusion
    • Organic uterine bleeding
      • Bleeding related to systemic illness or disease of the reproductive tract


  • Anovulatory (most common):
    • Unopposed estrogen stimulation of proliferative endometrium
    • Alteration of neuroendocrine function due to:
      • Polycystic ovarian syndrome (PCOS)
      • Very low calorie diets, rapid weight change, intense exercise, anorexia
      • Psychological stress
      • Obesity
      • Drugs
      • Hypothyroidism
      • Primary hypothalamic dysfunction
  • Ovulatory:
    • Inadequate uterine PGF2α
      • Increased uterine contractility
    • Excessive uterine prostacycline
      • Diminishes platelet function and increases uterine vasodilation

Pediatric Considerations
Anovulatory bleeding common in adolescence owing to immaturity of the hypothalamic–pituitary–ovarian axis

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Rosen, Peter, et al., editors. "Dysfunctional Uterine Bleeding." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307087/all/Dysfunctional_Uterine_Bleeding.
Dysfunctional Uterine Bleeding. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307087/all/Dysfunctional_Uterine_Bleeding. Accessed April 25, 2019.
Dysfunctional Uterine Bleeding. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307087/all/Dysfunctional_Uterine_Bleeding
Dysfunctional Uterine Bleeding [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307087/all/Dysfunctional_Uterine_Bleeding.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Dysfunctional Uterine Bleeding ID - 307087 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307087/all/Dysfunctional_Uterine_Bleeding PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -