Abnormal and Dysfunctional Uterine Bleeding Flashcards
Difference between Abnormal Uterine Bleeding (AUB) and dysfunctional uterine bleeding (DUB).
AUB: any pattern of bleeding other than regular ovulatory cycles. DUB: is AUB not attributed to medications, blood dyscrasias, systemic disease, trauma, infections, uterine neoplasia or pregnancy. It’s a diagnosis of exclusion.
What usually occurs 24 hours after the LH surge?
Ovulation
Which mediator causes ischemia of the endometrial vessels to prevent excessive bleeding during menses.
Prostaglandins
Why do anovulatory cycles lead to heavier bleeding?
Unopposed estrogen causes endometrial hyperplasia as well as uncoordinated sloughing of the endometrium, leading to asynchronous bleeding. The problem is that less PGs are being produced and less endometrial vessel vasoconstriction. The result is heavier bleeding.
What is menorrhagia?
Excessive or prolonged uterine bleeding. Greater than 80cc or longer than 7 days.
What is Polymenorrhagia?
Frequent menses, less than 21 days between bleeding.
What is Metrorrhagia?
Irregular menses at unexpected times.
What is Menometrorrhagia?
Heavy irregular menses
What is Oligomenorrhea?
Continuous intervals lasting longer than 35 days for a 6 month period.
What is Amenorrhea?
No menses for 3 months
Main blood dyscrasia that causes AUB.
Von Willebrands Disease
Most common systemic disease that causes AUB.
Hypothyroidism
What is the time frame and most common cause of Dysfunctional Uterine Bleeding.
Usually occurs around menarche and menopause. Almost always caused by hypothalamic-pituitary-ovarian axis pathology resulting in anovulation.
What is the DDx for AUB?
PALM COEIN Polyps Adenomyosis Leiomyomata (same thing as fibroid wtf is with the different words?) Malignancy Coagulopathies Ovulatory Endometrial Iatrogenic Not Classified
First step for any workup of DUB.
RULE OUT PREGNANCY (then rule out malignancy)
