Abnormal Uterine Bleeding (AUB)

Question 1

What is this?

What does it indicate?

What’s it called if it occurs between well-defined menstrual cycles?

What’s it called when it’s related to hormonal changes that directly affect the menstrual cycle?

Answer 1

➊ Irregularities from a normal menstrual cycle – Includes frequency, duration, cycle length, volume of menses

➋ Anovulation or irregular ovulation

➌ Intermenstrual bleeding

➍ Dysfunctional Uterine bleeding

Question 2

What are its structural causes?

What are its non-structural causes?

Answer 2

➊ • Polyps – endometrial, cervical
• Adenomyosis
• Fibroid
• Malignancy

➋ • Coagulopathy
• Ovulatory dysfunction
• Endometrial disorders
• Iatrogenic

Question 3

Which investigations should be done?

What is important to rule out?

Answer 3

➊ • Bedside – Cervical smear
• Bloods – FBC
• Special – Pelvic US, Pelvic infection screening, Hysteroscopy and biopsy, MRI

➋ Pregnancy! and any red flags e.g. cancer