Dysfunctional uterine bleeding

Question 1

What is dysfunctional uterine bleeding?

Answer 1

Menorrhagia that has no pathological cause, or bleeding between monthly periods, or prolonged bleeding

Question 2

What are the other causes of menorrhagia?

Answer 2

Fibroids
Endometriosis
PCOS
PID
Contraceptives
Bleeding disorders
Endometrial cancer
Anticoagulant medications
Adenomyosis

Question 3

What investigations should be performed in someone with heavy menstrual bleeding?

Answer 3

FBC for iron deficiency anaemia
Bimanual pelvic examination
Speculum examination

Question 4

What investigations may be performed in someone with heavy menstrual bleeding?

Answer 4

Transvaginal ultrasound
Hysteroscopy
Swabs
Coagulation screen
TFT
Ferritin

Question 5

What is the non-hormonal management of dysfunctional uterine bleeding?

Answer 5

Tranexamic acid if there is no associated pain
Mefenamic acid if there is associated pain

Question 6

What is the first line hormonal management of dysfunctional uterine bleeding?

Answer 6

Mirena coil

Question 7

What are the second line hormonal management options for dysfunctional uterine bleeding?

Answer 7

COCP
Cyclical oral progestogens e.g norethisterone

Question 8

What are the third line management options for dysfunctional uterine bleeding?

Answer 8

Endometrial ablation
Hysterectomy

Question 9

What is the definition of menorrhagia?

Answer 9

Heavy menstrual bleeding that has an impact on day to day life (or is >80ml)