Abnormal Bleeding in a Reproductive Age Woman

by / Thursday, 05 August 2010 / Published in OB/GYN

With the presence of abnormal bleeding, first thing is to rule out “PAD”:

P- pregnancy

A – anatomical abnormalities

D – dysfunctional uterine bleeding

Dysfunctional Uterine Bleeding (DUB):

  • Anatomic menstruation without anatomic lesions of the uterus
  • Is most commonly due to chronic estrogen stimulation
  • Abnormal bleeding is defined as bleeding at intervals <21 days or >36 days, lasting >7 days, or blood volume loss >80ml

Diagnosis:

  • R/O anatomic causes (fibroids, cervical or vaginal lesions, infections, cervical and/or endometrial cancer)
  • Evaluate factors that can affect the hypothalamus-pituitary axis (stress, excessive exercise, weight changes, systemic disease, coagulopathies, pregnancies)

Treatment:

  • Give progesterone from day 14-25 of menstrual cycle
  • Birth control pills are an alternative

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