Abnormal Uterine Bleeding
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)
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