Dysfunctional Uterine Bleeding

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

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Basics

Description

  • 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

Etiology

  • 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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Citation

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TY - ELEC T1 - Dysfunctional Uterine Bleeding ID - 307087 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307087/all/Dysfunctional_Uterine_Bleeding ER -