Many women have variations in their menstrual cycle, such as changes in frequency, duration, or amount of flow, or spotting between their periods. This abnormal uterine bleeding (AUB) may have various causes, some of them benign. But when AUB is related to changes in hormones that directly affect the menstruation cycle, the condition is called dysfunctional uterine bleeding (DUB).
Make no mistake, AUB and DUB can be incapacitating because of either the fear of flooding or feeling weak from blood loss. A woman who's experiencing abnormalities in her menstrual cycle should be evaluated to determine the reason.
Dysfunctional uterine bleeding (DUB) affects at least 1/3 of women at some point in life. Problems can start at any time, such as during the first menstrual cycle all the way up to menopause. This condition affect’s the body’s ovulation cycle. Instead of following a normal 21-35-day menstrual cycle, DUB occurs at random times during the month.
This chapter covers a complaint that ranges from mostly benign to life threatening, and covers causes and management.
Dysfunctional uterine bleeding (DUB) is
defined as excessively heavy, prolonged or
frequent bleeding of uterine origin that is not
due to pregnancy or any recognisable pelvic
or systemic disease. It is, therefore, a diagnosis of exclusion.
Dysfunctional uterine bleeding (DUB) is defined as excessive, prolonged, or unpatterned bleeding from the uterine endometrium that is not related to anatomic lesions of the uterus. DUB is the most frequent urgent gynecologic problem of the adolescent. Organic causes of DUB include coagulation defects, pathology involving the reproductive tract, infections, systemic diseases, trauma, and local lesions; these must be ruled out before a diagnosis of anovulation is made.
Dysfunctional uterine bleeding is one of the most common reasons patients seek the opinion of a gynecologist.
Dysfunctional bleeding is another term with varying definitions. Some consider bleeding dysfunctional if there is any abnormal uterine bleeding in the absence of uterine pathology or medical illness. Others feel that drawing such a fine distinction is pointless as many medical illnesses (polycystic ovary syndrome, hypothyroidism, hyperthyroidism, adrenal hyperplasia) can create a pattern of bleeding that is clinically indistinguishable from the traditional "dysfunctional" uterine bleeding. Many gynecologists use the term abnormal uterine bleeding (AUB) and dysfunctional uterine bleeding (DUB) interchangeably.
“Someone’s menstrual period should not be impairing them from leading a normal life, because we have really good treatments for pain and for heavy bleeding,” an expert says.
Compared to normal menstruation, the highly localized and unpredictable nature of dysfunctional bleeding represents a distinctly different biological entity.
Most often, these irregularities occur due to hormonal imbalances, but there are other conditions which can produce similar symptoms.
Dysfunctional uterine bleeding is defined as abnormal uterine bleeding in the absence of uterine pathology or medical illness. It is more often seen in the pubertal and perimenopausal periods, and in most cases, it is associated with anovulation, leading to lack of estrogen-induced negative feedback on the pituitary gland, resulting in unopposed estrogen stimulation to the endometrium.
If patient ovulates, may be due to inadequate proliferative phase, inadequate secretory phase, irregular shedding or membranous dysmenorrhea. Anovulatory cycle: proliferative endometrium during chronological secretory phase; usually causes endometrial hyperplasia.