Saturday, February, 11, 2012

Dysfunctional uterine bleeding (DUB)

Table of Contents

Alternative Names

Anovulatory bleeding; Bleeding - dysfunctional uterine; DUB; Abnormal uterine bleeding; Menorrhagia - dysfunctional; Polymenorrhea - dysfunctional; Metrorrhagia - dysfunctional


Symptoms

A woman with dysfunctional uterine bleeding may notice the following changes in her menstrual cycle:

  • Bleeding or spotting from the vagina occurs between periods
  • Menstrual periods may be less than 28 days (more common) or more than 35 days apart
  • Time between menstrual periods changes with each cycle
  • Bleeding is heavier (passing large clots, needing to change protection during the night, soaking through a sanitary pad or tampon every hour for 2 - 3 hours in a row)
  • Bleeding lasts for more days than normal or for more than 7 days

Other symptoms caused by changes in hormone levels are:

  • Excessive growth of body hair in a male pattern (hirsutism)
  • Hot flashes
  • Mood swings
  • Tenderness and dryness of the vagina

A woman may feel tiredness or fatigue if she is losing too much blood over time and becomes anemic.


Signs and tests

The health care provider will do a pelvic examination.

Lab tests may include:

  • CBC
  • Blood clotting profile
  • Hormone tests
    • FSH
    • LH
    • Male hormone (androgen) levels
    • Prolactin
    • Progesterone
  • Serum or urine HCG (to rule out pregnancy)
  • Thyroid function tests
  • Culture to look for infection

The following procedures may be done:

  • Endometrial biopsy may be done to look for infection, precancer, or cancer, or to help decide on hormone treatment.
  • Hysteroscopy is an office procedure in which the doctor inserts a flexible tube with a light and a tiny camera on the end into the uterus through the vagina.
  • Transvaginal ultrasound may be done to look for abnormalities in the uterus or pelvis.

Review Date: 09/02/2009
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Facility, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)