Abnormal uterine bleeding Flashcards
Def: Menorrhagia
prolonged and increased menstrual blood flow
Def: Metrorrhagia
Regular, heavy intramenstrual bleeding
Def: Polymenorrhoea
Frequent menses occurring at <21 day intervals
Def: Polymenorrhagia
Increased bleeding and frequent cycles
Def: Menometrorrhagia
Prolonged menses and intramenstrual bleeding
Def: Amenorrhoea
Absence of menstruation > 6 months
Def: Oligomenorrhoea
Menses at intervals of >35 days
Def: Dysfunctional uterine bleeding
AUB with no organic cause (Disruption in normal cyclical pattern)
How does dysfunctional uterine bleeding occur?
Anovulatory cycles, commonly at either end of reproductive life due to non-formation of the corpus luteum
Def: Post-menstrual bleeding
AUB >1 year after cessation of menstruation
What are some pre-pubertal or adolescent causes of AUB?
- Precocious piuberty (Hypothalamic, pituitary or ovarian causes)
- Anovulatory cycles
- Bleeding/Coagulation disorders
What are some causes of AUB in reproductive years?
- Pregnancy/miscarriage
- Endometritis
- Endometrial/endocervical polp
- Leiomyoma
- Bleeding disorders
- Hyperplasia
- Neoplasia (cervical, endometrial)
Causes of postmenopausal AUB
- Endometrial atrophy
- Endometrial polyp
- Exogenous hormones (HRT, tamoxifen)
- Endometritis
- Bleeding disorders
- Endometrial lesions - Hyperplasia, carcinoma or sarcoma
What are some important history points in AUB?
- Age
- Date of LMP and length of cycle
- Pattern of bleeding
- Hormones? - Contraception, HRT, Tamoxifen
- Recent pregnancy
What are some examinations used in AUB?
Trans-vaginal US assessing endometrial thickness
Hysteroscopy
Biopsy
What endometrial thickness in postmenopausal women is considered indication for biopsy?
> 4mm
What endometrial thickness in premenopausal women is considered indication for biopsy?
> 16mm
What are some methods for biopsy of the endometrium
Endometrial pipette
Dilatation and curettage
