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Dysfunctional uterine bleeding (DUB)

  • Alternative Names

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


    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.