Abnormal Uterine Bleeding

Definition

Abnormal uterine bleeding may be occur due to hormonal imbalance or structural abnormality. It
is related to abnormal endometrial bleeding without recognizable organic lesions. It is also
indication for almost 25% of gynecologic surgical procedures. In which the prognosis also varies
with the cause, it may be occur due to hormonal imbalance. So the correction of hormonal
imbalance or structural abnormality usually corrects the problem.

Causes of Abnormal uterine bleeding

It may be cause by imbalance in the hormonal-endometrial relationship. Because in which
persistent and unopposed stimulation of the endometrium by estrogen occurs. If progesterone
secretion is absent then estrogen secretion continues. When ovulation doesn't occur, then
endometrium is randomly broken down, and exposed vascular channels cause prolonged and
excessive bleeding. But in most cases of abnormal uterine bleeding, endometrium shows no
pathologic changes. But, in chronic unopposed estrogen stimulation, the endometrium may show
hyperplastic or malignant changes. Various possible causes that may be occur due to disorders
and it may cause sustained high estrogen levels such as

 Polycystic ovary syndrome

 Obesity
 Immaturity of the hypothalamicpituitary-ovarian mechanism
 Anovulation
 Trauma
 Endometriosis
 Coagulopathy
 Dug-induced coagulopathy

Symptoms of Abnormal uterine bleeding

Abnormal uterine bleeding have various symptoms such as:

 Metrorrhagia
 Hypermenorrhea
 Chronic polymenorrhea or oligomenorrhea
 Fatigue due to anemia
 Oligomenorrhea and infertility due to anovulation

Other possible complications of abnormal uterine bleeding such as iron deficiency anemia that
may be caused by blood loss of more than 1.6L over a short time, hemorrhagic shock or right-
sided heart failure and endometrial adenocarcinoma due to chronic estrogen stimulation.
Treatment of Abnormal uterine bleeding

If you have this disease, then you should be use Possible treatment such as:

 You should be taken high-dose estrogen-progestogen to control endometrial growth and

reestablish a normal cyclic pattern of menstruation.
 If patients age 35 and older, then you should be use endometrial biopsy to rule out
endometrial adenocarcinoma.
 Another alternative for many women is progestogen therapy such as those susceptible to
such adverse effects of estrogen as thrombophlebitis.
 You can also used iron supplementation or transfusions of packed cells or whole blood
that may be occur due to anemia caused by recurrent or excessive bleeding.
 To prevent abnormal bleeding due to organic causes and for early detection of
malignancy, encourage the patient to have a Papanicolaou test and a pelvic examination
annually.
 If a patient has complains of abnormal bleeding, then you should tell her to record the
dates of the bleeding and the number of pads.