Abnormal uterine bleeding is a common reason for women of all ages to consult their family physicians. Terms used to describe patterns of abnormal uterine bleeding are based on periodicity and quantity of flow . Dysfunctional uterine bleeding (DUB), defined as abnormal uterine bleeding not caused by pelvic pathology, medications, systemic disease or pregnancy, is the most common cause of abnormal uterine bleeding but remains a diagnosis of exclusion.
Terminology Used to Describe Abnormal Uterine Bleeding
| Term | Definition |
|---|---|
| Menorrhagia | Prolonged or excessive bleeding at regular intervals |
| Metrorrhagia | Irregular, frequent uterine bleeding of varying amounts but not excessive |
| Menometrorrhagia | Prolonged or excessive bleeding at irregular intervals |
| Polymenorrhea | Regular bleeding at intervals of less than 21 days |
| Oligomenorrhea | Bleeding at intervals greater than every 35 days |
| Amenorrhea | No uterine bleeding for at least 6 months |
| Intermenstrual | Uterine bleeding between regular cycles |
Differential Diagnosis of Abnormal Uterine Bleeding
- • Complications of pregnancy
- • Intrauterine pregnancy
- • Ectopic pregnancy
- • Spontaneous abortion
- • Gestational trophoblastic disease
- • Placenta previa
- • Placenta previa
- • Infection
- • Cervicitis
- • Endometritis
- • Trauma
- • Laceration, abrasion
- • Foreign body
- • Malignant neoplasm
- • Cervical
- • Endometrial
- • Ovarian
- • Benign pelvic pathology
- • Cervical polyp
- • Endometrial polyp
- • Leiomyoma
- • Adenomyosis
- • Systemic disease
- • Hepatic disease
- • Renal disease
- • Coagulopathy
- • Thrombocytopenia
- • von Willebrand’s disease
- • Leukemia
- • Medications/iatrogenic
- • Intrauterine device
- • Hormones (oral contraceptives, estrogen, progesterone)
- • Anovulatory cycles
- • Hypothyroidism
- • Hyperprolactinemia
- • Cushing’s disease
- • Polycystic ovarian syndrome
- • Adrenal dysfunction/tumor
- • Stress (emotional, excessive exercise)