Dysfunctional uterine bleeding
Dysfunctional uterine bleeding, also known as anovulatory bleeding, is a type of bleeding that differs from a woman’s normal menstrual cycle. It occurs when hormonal signals are disrupted, leading to alternating heavy and light periods, spotting, or unpredictable cycles.
Factors that can cause irregular bleeding include hormonal abnormalities, medications, excessive exercise, obesity, stress, the start of menstruation in adolescence, and the end of menstruation.
Symptoms of dysfunctional uterine bleeding can range from light to heavy, with large clots and uterine cramps. Diagnosing dysfunctional uterine bleeding involves a doctor checking for pregnancy, thyroid hormone and prolactin hormone abnormalities, menopause, uterus or ovaries abnormalities, possible cancer, or anemia. The expected duration of dysfunctional uterine bleeding is typically a few months or years, with irregular periods signaling the beginning of menopause.
According to the Harvard classification, DUB is categorized primarily into two types: ovulatory and anovulatory bleeding. Ovulatory DUB typically presents with normal hormonal levels but irregular timing of menstruation, while anovulatory DUB results from a lack of ovulation, leading to unpredictable bleeding patterns due to unopposed estrogen stimulation.
The FIGO classification further refines the understanding of abnormal uterine bleeding by establishing a classification that identifies structural causes such as polyps or fibroids, as well as non-structural causes including coagulopathies and systemic disorders, in short words (PALM-COIEN) abbreviation stands for:
1- Polyp 2- Adenomyosis 3- Leiomyoma. 4- Malignancy. 5- Coagulopathy 6- Ovarian 7- Iatrogenic 8- Endometrial 9- Not yet classified
FIGO allows healthcare providers to develop targeted treatment plans based on the underlying etiology of the bleeding.
Dysfunctional uterine bleeding is a condition that cannot be prevented, but early diagnosis and treatment can help restore regular periods.
Treatment depends on the cause, bleeding amount, and the woman’s reproductive goals. Birth control pills, hormone pills, and surgical procedures can help regulate and decrease bleeding.
If you notice heavy vaginal bleeding not related to your regular cycle call your doctor immediately. Treatments include hormone pills to stimulate ovulation, but irregular periods do not mean infertility. Protection against pregnancy is still necessary when sexually active.
Dysfunctional uterine bleeding is a condition that cannot be prevented, but early diagnosis and treatment can help restore regular periods. Treatment depends on the cause, bleeding amount, and the woman’s reproductive goals. Birth control pills, which combine estrogen and progesterone, can regulate and decrease bleeding.
Heavy bleeding can be stopped with higher doses of hormone pills, and if hormonal therapy fails, a surgical D and C (dilation and curettage) can stop severe cases. Endometrial hyperplasia, a thicker and abnormal lining, may require closer monitoring and treatment, especially in older women and postmenopausal women on hormone replacement therapy.