Dysfunctional Uterine Bleeding

Dysfunctional uterine bleeding

Dysfunctional uterine bleeding is abnormal bleeding resulting from changes in the normal hormonal control of the menstruation.

  • Dysfunctional uterine bleeding occurs most commonly at the beginning and end of reproductive years.
  • 20% of the cases occur in adolescent girls and more than 50% occur in women older than 45.
  • Dysfunctional uterine bleeding commonly results when the level of estrogen remains high.
  • High levels of estrogen are not balanced by appropriate levels of progesterone and release of egg does not occur.
  • As a result, the lining of the uterus thickens.
  • This condition is called endometrial hyperplasia.
  • The lining is then shed incompletely and irregularly, which causes bleeding.
  • Bleeding is irregular, prolonged and sometimes heavy.
  • This type of bleeding is common in women who have polycystic ovarian syndrome.

Diagnosis

  • Dysfunctional uterine bleeding is diagnosed when all other possible causes of vaginal bleeding have been excluded.
  • The results of a blood test can help doctors estimate the extent of the blood loss.
  • Tranvaginal sonography may be used to determine whether the uterine lining is thickened.
  • If the risk of the cancer of the uterine lining is high, an endometrial biopsy is performed before drug treatment is stated.
  • Women at risk include those who are 35 years or older, those who are substantially overweight and those who have polycystic ovarian syndrome, high blood pressure or diabetes.

Treatment

  • Treatment depends on woman’s age, how heavy the bleeding is whether the uterine lining is thickened and whether the woman wishes to become pregnant.
  • When the uterine lining is thickened but its cells are normal, hormones may be used.
  • Women who have heavy bleeding may be treated with oral contraceptives containing estrogen and progestin.
  • When bleeding is very heavy, estrogen may be given intravenously until the bleeding stops.
  • Sometimes progestin is given by mouth at the same time or started 2 or 3 days later.
  • Bleeding usually stops in 12 to 24 hours.
  • Low doses of oral contraceptives may be prescribed for at least 3 months.
  • Treatment given with oral contraceptives or intravenous estrogen may be inappropriate for some women like postmenopausal women or women with significant risk factors for heart or blood vessel disease.
  • These women may be given progestin alone by mouth for 10 to 14 days each month.
  • For women, who wish to become pregnant, clomiphene may be given by mouth.
  • If the uterine lining remains thickened or bleeding persists despite the treatment with hormones, dilation and curettage is usually needed.
  • In this procedure, tissue from the uterine lining is removed by scraping.
  • When the uterine lining is thickened and contains abnormal cells, particularly in women who are older than 35 years and women who don’t want to become pregnant, treatment begins with a high dose of progestin.
  • If the cells continue to be abnormal after treatment, a hysterectomy is performed, because the abnormal cells may become cancerous.

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By | 2018-06-01T09:44:25+00:00 December 24th, 2017|Disease/pathological condition|2 Comments

About the Author:

B. Pharm (K.L.E. society's S.V.V. Patil College of Pharmacy, Bengaluru) M. Pharm (Maharishi Arvind Institute of Pharmacy, Jaipur)

2 Comments

  1. Shalini February 13, 2018 at 5:52 pm - Reply

    Thanks for the information, Dhruv!
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  2. pinoy tv April 14, 2018 at 6:05 pm - Reply

    Thanks for sharing this good information. I like is very much, please keep it up

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