Patient resources gynaecologist windsor, berkshire. Gynecology the two figo systems for normal and abnormal. Abnormal uterine bleeding can be caused by many different conditions. About onethird of all women experience abnormal uterine bleeding aub sometime during their lifetime and aub can impair quality of life. Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. Evaluation and management of abnormal uterine bleeding in premenopausal women. Adolescents in particular may have tremendous variability in their cycles until their hormone levels balance out after several years of menstruation. 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.
Menstrual flow outside of normal volume, duration, regularity, or frequency is considered abnormal uterine bleeding. Hkcog guidelines number 5 may 2001 1 hkcog guidelines guidelines on investigation of women with abnormal uterine bleeding under the age of 40 published by the hong kong college of obstetricians and gynaecologists a foundation college of hong kong academy of medicine number 5 may 2001 1 introduction abnormal uterine bleeding aub is a. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. Treatment options for the adolescent patient experiencing. Abnormal uterine bleeding in premenopausal women replaces no. To design a universally accepted system for describing bleeding problems in reproductiveaged women, a new classification system was created named for the acronym palmcoein polyp, adenomyosis, leiomyoma, malignancy and hyperpla. In cases of acute and severe bleeding, women may need urgent treatment with. Abnormal uterine bleeding is a common condition, with a prevalence of 10% to 30% among women of reproductive age. Abnormal uterine bleeding aub is a broad term that describes irregularities in. Endometrial biopsy results in women with abnormal uterine. 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. Of these cases of aub, about 90% are due to menstrual.
Guidelines for the management of abnormal uterine bleeding. Laboratory workup of adolescents with abnormal uterine bleeding should include a preg. As the most common cause of abnormal uterine bleeding, it affects both ends of the reproductive spectrum that is, teens and perimenopausal women. 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. Many, however, are unaware of common causes of abnormal bleeding and available treatment options. Diagnosis of abnormal uterine bleeding in reproductiveaged women. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. Abnormal uterine bleeding aub in nonpregnant women is a common problem. Abnormal uterine bleeding aub may be acute or chronic and is defined as. An overview of postmenopausal bleeding by marinelle platonjones, do, gigi kwok, md, and jennifer keehbauch, md 1 figure 1. It may be caused by trauma, a foreign body such as toys, coins, or toilet tissue, irritation of the genital area due to bubble bath, soaps, lotions, or infection, or urinary tract problems. Aub is responsible for significant health problem and social embarrassment and it is one of the common reasons women seek health care. The reasons for the wide spectrum of estimatesare unclear but vary with age, being higher in adolescents and in the fifthdecade of life, and varying somewhat with country of. Acog releases guidelines on management of abnormal uterine.
With a focus on common patient questions and concerns, topics include. Abnormal uterine bleeding aub is a condition that affects approximately 30% of women during their reproductive years. Diagnosing the cause of abnormal uterine bleeding starts with a. One third of outpatient visits to the gynecologist are for aub, and it accounts for more than 70% of all gyne. The panel concluded that after a diagnostic workup has excluded structural and endometrial pathology, medical therapy is the preferred firstline treatment for uterine bleeding associated with. 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 national health portal of india.
Abnormal uterine bleeding is a very common condition among women of any age. Management of abnormal uterine bleeding in reproductive. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. Abnormal uterine bleeding healthcare baylor college of.
Blood samples were collected on the next day or on the same day if patients were fasting. Single measurement of serum prolactin was done in the. The american college of obstetricians and gynecologists has issued new guidelines for managing excessive or irregular bleeding caused by. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience.
Bleeding or spotting between periods bleeding or spotting after sex heavy bleeding during your period menstrual cycles that are longer than 38 days or shorter than 24 days irregular periods in which cycle length varies by more than 7. Abnormal dysfunctional uterine bleeding in pediatrics. All such women therefore need uterine assessment, which may include transvaginal scan combined with endometrial biopsy, hysteroscopy or a sonohysterogram. Aub frequently coexists with fibroids, but the relationship between the two remains. Once conditions of pregnancy, infection, structural abnormalities, and hormonal causes have been ruled out, firstline treatment is medical. Bleeding in any of the following situations is considered abnormal uterine.
The medical management of abnormal uterine bleeding in. 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 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. Postmenopausal bleeding pmb refers to any uterine bleeding in a menopausal woman other than the expected cyclic bleeding that occurs in women taking cyclic postmenopausal hormone therapy. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause.
Classification and the diagnostics of abnormal uterine. Abnormal uterine bleeding occurs in 9 to 14 percent of women between menarche and menopause, significantly impacting quality of life and imposing financial burden. Abnormal uterine bleeding is a frequent condition in gynecology. 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. 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. Heavy menstrual bleeding at menarche and in adolescence may be an important. Anovulatory uterine bleeding abnormal uterine bleeding aub. The management of perimenopausal abnormal uterine bleeding. Half of all hysterectomies in the united states are performed to treat abnormal uterine bleeding. Management of abnormal uterine bleeding associated with ovulatory dysfunction. Abnormal uterine bleeding in the adolescent patient 26 the female patient vol 35 july 2010 all articles are available online at females should receive testing for sexually transmitted infections. The two figo systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years. Bleeding that occurs erratically or excessive regular menstrual bleeding is considered to be abnormal uterine bleeding. Evaluation and management of abnormal uterine bleeding in.
The american college of obstetricians and gynecologists has issued updated guidelines for treating abnormal uterine bleeding caused by ovulatory dysfunction. 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. Algorithm for work up of postmenopausal bleeding 7 introduction postmenopausal bleeding pmb refers to an episode of bleeding in a woman who had her final menstrual period 12 or more months ago. Being one of the common gynecological problems we did this study to find out the hospital prevalence, causes and management at chitwan medical college. Abnormal dysfunctional uterine bleeding medication. It reflects an abnormal volume of blood loss during the menstrual cycle. Howeve r, there are rare hormonal conditions that cause abnormal uterine bleeding in ovulatory cycles. Dec 07, 2018 dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of pathology or medical illness. Abnormal uterine bleeding is a common problem,1 and its management can be complex.
Abnormal uterine bleeding associated with ovulatory dysfunction aubo is a condition for which women frequently seek gynecologic care. One third of outpatient visits to the gynecologist are for aub, and it accounts for more than 70% of all gynecologic consults in the perimenopausal and postmenopausal years 1. Abnormal uterine bleeding investigations bmj best practice. Endometrial ablation refers to a number of minimally invasive surgical procedures designed to treat abnormal uterine bleeding in selected women who have no desire for future fertility. Abnormal uterine bleeding in young girls bleeding before menarche the first period in a girls life is always abnormal.
Its prevalence, causes and management in chitwan abstract abnormal uterine bleeding is a common morbid condition of woman seeking medical advice. Acog, this article uses the term anovulatory abnormal uterine bleeding. In this document, standard resectoscopic endometrial ablation will be compared with the newer nonresectoscopic endometrial ablation devices and techniques. Abnormal uterine womb bleeding is a common problem in women.
Sep 11, 2015 in premopausal women with normal findings on physical examination, the most likely diagnosis is dysfunctional uterine bleeding dub secondary to anovulation, and the diagnostic investigation is targeted at identifying the etiology of anovulation. 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. Medical management of abnormal uterine bleeding in. Management of abnormal uterine bleeding in reproductive period. Aub leads to loss of productivity1 and may result in surgical interventions including hysterectomy2. The acronym palmcoein polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory. This type of bleeding may include spotting of small amounts of blood between periods often seen on toilet tissue after wiping or extremely heavy periods in which you soak a pad or tampon every one to two hours for two or more hours. Acog practice bulletin 128 on diagnosis of abnormal uterine bleeding in reproductiveaged women 22914421 obstet gynecol 2012 jul. It accounts for approximately 5 percent of office gynecology visits. 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 aub is the name currently used for changes in.
The term dysfunctional uterine bleeding was used when no underlying cause was present. The worldwide impact of abnormal uterine bleeding aub in the reproductiveyears is substantial,with a prevalenceof approximately 3%30% among reproductiveaged women. As a result, in ovulatory dysfunctional uterine bleeding, treatment with prostaglandin synthetase inhibitors are more effective than hormonal treatment. Abnormal uterine bleeding marquette general hospital. Health care practitioners deal with this problem frequently. Acog releases guidelines on management of abnormal. Abnormal uterine bleeding dysfunctional uterine bleeding ncbi. Chronic heavy or prolonged uterine bleeding can result in anemia, interfere with daily activities, and raise concerns about uterine cancer. Chronic heavy or prolonged uterine bleeding can result in anemia, interfere with daily activities, and raise concerns about uterine. Abnormal uterine bleeding aub is a common and debilitating condition with high direct and indirect costs. Treatment options for dysfunctional uterine bleeding.
Approach to abnormal uterine bleeding in nonpregnant reproductiveage women. Abnormal uterine bleeding is further clas occurs less frequently than every 35 days. Management of abnormal uterine bleeding wesley obgyn. Once a woman who is not taking hormone therapy enters menopause and the menstrual cycles have ended, any uterine bleeding is considered abnormal. 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. Prolactin level in women with abnormal uterine bleeding. A normal menstrual period generally lasts up to 8 days. Jul 08, 2019 aub occurs most often in the beginning and end of the reproductive years. Abnormal vaginal bleeding is any vaginal bleeding unrelated to normal menstruation. The abnormal uterine bleeding pamphlet presents easytoread information for patients with this condition. Abnormal uterine bleeding aub is a common problem among women in the reproductive age. Menstrual flow outside of normal volume, duration, regularity, or frequency is considered abnormal uterine bleeding aub. Aub is responsible for significant health problem and social embarrassment and.
Anovulatory uterine bleeding is the primary cause of aub in adolescents and generally resolves with maturation of the hypothalamicpituitaryovarian axis. The figo systems first define the abnormal uterine bleeding, then give an. Pdf on jan 1, 2012, micah j hill and others published acog practice bulletin. It is one of the most common health issues for women. Review what is normal bleeding and what is not normal. Aub may be accompanied by pain and discomfort, cause significant social embarrassment, and have a substantial effect on healthrelated quality of life.
Teens typically experience dub during the first 2 years after menarche begins, when their hypothalamicpituitaryadrenal axis hpa axis is immature. Hkcog guidelines number 5 may 2001 hkcog guidelines number. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. Uterine leiomyomas are very common, with some studies reporting leiomyomas in 70% of white women and more than 80% of black women by age 50 years 2. A common and often debilitating condition, affecting women of reproductive age. African american 4 women are more likely to have nonendometrioid, highgrade tumors known as type ii, which are associated with a more advanced stage of disease stage iii and stage iv at the time of diagnosis, compared with caucasian. Evaluation of adolescent girls who present with heavy menstrual bleeding should. A new classification system has been created to provide a universally accepted system of nomenclature to describe uterine bleeding causes in reproductiveaged women. Abnormal uterine bleeding aub is a common problem among nonpregnant women in the reproductive age. Abnormal uterine bleeding can occur as either a change in your normal menstrual period or as bleeding in between your normal menses. Clinical diagnosis of abnormal uterine bleeding was established based on the history provided by the patients. Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. Of these, approximately 20% are performed in women with a normal uterine size.
The objective of this study was to evaluate the endometrial biopsy patterns in an indigent population of women with abnormal uterine bleeding. Abnormal uterine bleeding around the time of the menopause is common and may be a sign of premalignancy such as endometrial hyperplasia or even endometrial carcinoma. One third of outpatient visits to the gynecologist are for aub, and it accounts for more than 70% of all gynecologic consults in. Abnormal uterine bleeding aub is one of the most common reasons adolescent patients present for gynecologic care. The american college of obstetrics and gynecology acog has. Approach to abnormal uterine bleeding in nonpregnant reproductive. Abnormal uterine bleeding related to ovulatory dysfunction i. Abnormal uterine bleeding in the adolescent patient. Jun 26, 20 updated patient management guidelines for the treatment of patients with abnormal uterine bleeding associated with ovulatory dysfunction have been released in a practice bulletin published in the. Diagnosis of abnormal uterine bleeding in reproductive. Introduction abnormal uterine bleeding aub is a common problem among women in the reproductive age. Ppt abnormal uterine bleeding powerpoint presentation. Bleeding in any of the following situations is considered abnormal uterine bleeding. Abnormal uterine bleeding is bleeding that is different from a womans normal menstrual cycle, unrelated to menstruation, or unusual for her age.
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