Dysfunctional Uterine Bleeding

Question 1

What is dysfunctional uterine bleeding?

Answer 1

Abnormal uterine bleeding in absence of underlying pathology.

Question 2

What is the aetiology of dysfunctional uterine bleeding?

Answer 2

Hormonal influences in anovulatory and (less commonly) ovulatory cycles. Common in extremes of reproductive age, and in obesity.

Question 3

What is the epidemiology of dysfunctional uterine bleeding?

Answer 3

10% of women

Question 4

What is the history and exam of dysfunctional uterine bleeding?

Answer 4

Menhorragia, IMB, associated dysmenhorrea.

General: signs of anaemia. Abdomen/pelvis exam normal

Question 5

What are the investigations of dysfunctional uterine bleeding?

Answer 5

Diagnosis of exclusion,

· Blood: FBC, TFT, clotting, hemanitics,

· Microbiology: HVS, endocervical.chlamydia swab.

· Imaging: pelvic USS (assess thickness, fibroids, ovaries)

· Tissue diagnosis: Pipelle biopsy, hysteroscopy in some subgroups to rule out endometrial hyperplasia or malignancy. Cervical smear too.

Question 6

What is the management of dysfunctional uterine bleeding?

Answer 6

Medical: tranaxemic acid, mefenamic acid, norethsterone, COCP, IUS.

Question 7

What are the complications and prognosis of dysfunctional uterine bleeding?

Answer 7

Disruption of activities, profound anaemia,

Majority relieved with medical tx, some reuqire surgery.