39) Dysfunctional Uterine Bleeding - Metrophatia Hemorrhagica juvenilis (adolescent) & climacterica (climacteric bleeding)

Question 1

What is the definition of Dysfunctional Uterine Bleeding?

Answer 1

• It’s abnormal uterine bleeding due to disrupted cyclic hormonal changes of menstrual cycle (anovulation)

Question 2

What are examples of Abnormal Uterine bleeding?

Answer 2

1) MeNorrhagia = excessive bleeding for more than 7 Days

2) MeTRorrhagia = Bleeding occurs between regular cycles

Question 3

What are the Causes of DUB?

Answer 3

• Pregnancy - 1s Trimester bleeding
• PCOS
• Immaturity of Hypothalamic-Pituitary-Ovarian Axis - NORMAL at MENARCHE
• Dysfunction of Hypothalamic-Pituitary-Ovarian Axis

Question 4

What are the Possible Reasons for 1st Trimester DUB?

Answer 4

• Abortion
• Ectopic Pregnancy
• Molar Pregnancy
• Normal Early Pregnancy

Question 5

What are Examples of Dysfunction of Hypothalamic-Pituitary-Ovarian Axis?

Answer 5

• Hyperprolactinemia
• Stress / Anxiety
• Rapid Weight Loss
• Hypothyroidism
• Perimenopause - transitional period leading to menopause

Question 6

What is the Pathophysiology behind DUB?

Answer 6

1) NO Ovulation means NO Corpus Luteum production –> NO Production of Progesterone

2) Endometrium Growth due to Oestrogen

3) Results to superficial breakdown / bleeding

Question 7

What is the Diagnosis / Treatment for DUB?

Answer 7

DIAGNOSIS

• Endometrial Biopsy
• Ultrasound

TREATMENT

1) Hormonal Therapy - Progesterone Supplements, Oral Contraceptive Therapy

2) Endometrial Ablation