Dysfunctional Uterine Bleeding - Causes, Symptoms & Treatment

Dysfunctional uterine bleeding is heavy or irregular menstrual bleeding that is not caused by an underlying anatomical abnormality, such as a fibroid, lesion, or tumor. For example, your monthly menstrual period may happen more often than every 21 days or farther apart than 35 days. Your period may last longer than 7 days. In most cases, dysfunctional uterine bleeding is related to changes in hormone levels.

Dysfunctional uterine bleeding commonly results when the level of estrogen remains high. The high level of estrogen is not balanced by an appropriate level of progesterone, and release of an 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, causing bleeding. Bleeding is irregular, prolonged, and sometimes heavy. Dysfunctional uterine bleeding the most common cause of abnormal uterine bleeding, occurs most often in women > 45 ( > 50% of cases) and in adolescents (20% of cases).

The cause is usually estrogen production unopposed by progesterone, which can lead to endometrial hyperplasia. The endometrium sloughs and bleeds incompletely, irregularly, and sometimes profusely or for a long time. Endometrial hyperplasia, particularly atypical adenomatous hyperplasia, predisposes to endometrial cancer. Most women with DUB are anovulatory. Anovulation is usually secondary to polycystic ovary syndrome or idiopathic; the cause is sometimes hypothyroidism. Some women are anovulatory despite normal gonadotropin levels; the cause is idiopathic. About 20% of women with endometriosis have DUB due to unknown mechanisms.

Dysfunctional uterine bleeding is a disorder that occurs most frequently in women at the beginning and end of their reproductive lives. About half the cases occur in women over 45 years of age, and about one fifth occur in women under age 20. Diagnosis must be made by exclusion, since organic pathology must first be ruled out. It can be classified as ovulatory or anovulatory , depending on whether ovulation is occurring or not.

Dysfunctional uterine bleeding is not bleeding caused by medical conditions such as miscarriage , uterine growths such as fibroids , cancer of the cervix or uterus, or blood diseases. If you are having bleeding, your health professional must rule out these other conditions before diagnosing you with dysfunctional uterine bleeding.

Causes of Dysfunctional Uterine Bleeding

Find common causes and risk factors of Dysfunctional Uterine Bleeding:

• Other causes of DUB include structural disorders, such as functional ovarian cysts, cervicitis, endometritis, salpingitis, and leiomyomas.
• Pregnancy may be associated with bleeding that the patient may report as "abnormal" for her in terms of timing, amount, or duration.
• Polycystic ovary disease, infection, polyps, ectopic pregnancy, hydatidiform mole, blood dyscrasias, excessive weight gain, increased exercise performance, or stress may also contribute to DUB.

Signs and Symptoms of Dysfunctional Uterine Bleeding

Sign and symptoms may include the following :

• Infertility.
• Abnormal menstrual periods.
• bleeding between periods.

Treatment for Dysfunctional Uterine Bleeding

Treatment may include:

• Surgery, such as endometrial ablation .
• You should do regular checkups to assess the effectiveness of treatment.
• For the treatment of this disease, you should know about the importance of adhering to the prescribed hormonal therapy. If a D&C or endometrial ablation is ordered, explain this procedure and its purpose.
• Use of the levonorgestrel IUD , which releases a progesterone-like hormone into the uterus. This reduces bleeding while preventing pregnancy.
• Rarely used medications that stop estrogen production and menstruation, such as gonadotropin-releasing hormones. These medications can cause severe side effects but are used in special cases.

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