Prevalence of abnormal uterine bleeding according to new International Federation of Gynecology and Obstetrics classification in Chinese women of reproductive age

Abnormal uterine bleeding (AUB) is a common symptom in the female population, with an estimated prevalence of 10 to 30% in fertile age and up to 90% in perimenopausal women. In most cases, AUB is due to a benign cause. However, it can also be a symptom of atypical endometrial hyperplasia or endometrial cancer, a more common disease during menopause which can also affect women in their reproductive age. Considering the high prevalence of this symptom an appropriate diagnostic algorithm is needed. Concerns about the risks, pain, and stress associated with an endometrial biopsy and its impact on the healthcare system make the choice of AUB diagnostic strategy extremely relevant. Even if the scientific community agrees on the definition of AUB, International Guidelines show some differences in the management of women of reproductive age with AUB, especially regarding the age cut-off as an independent indication for endometrial biopsy. This study compared different diagnostic strategies to identify a diagnostic pathway with high sensitivity and specificity but low impact on the health system’s resources. The analysis was based on three diagnostic algorithms defined as part of the guidelines of leading scientific societies. Women of reproductive age with AUB (n = 625) and without risk of endometrial cancer were included in the study. Results showed that the best criterion to investigate AUB in women at low risk of endometrial cancer is not age cut-off but the presence or absence of focal endometrial pathology at the ultrasound and the response to the progestin therapy. This approach makes it possible to perform fewer outpatient hysteroscopic biopsies without excluding positive cases from the examination.

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Comprehensive therapy with myoinositol and D-chiroinositol in a 5:1 ratio for abnormal uterine bleeding in overweight and obese women

GYNECOLOGY ◽

10.26442/20795696.2021.5.201200 ◽

2021 ◽

Vol 23 (5) ◽

pp. 402-406

Author(s):

Alina V. Solovyeva ◽

Ildar F. Fatkullin ◽

Artur R. Akhmetgaliev ◽

Elena A. Vinokurova ◽

Ekaterina Yu. Aleynikova ◽

...

Keyword(s):

Follicle Stimulating Hormone ◽

Abnormal Uterine Bleeding ◽

Free Testosterone ◽

Serum Glucose ◽

Uterine Bleeding ◽

Reproductive Age ◽

Obese Women ◽

Women Of Reproductive Age ◽

Comprehensive Therapy ◽

Diet And Exercise

Background. Abnormal uterine bleeding (AUB) occurs in one-third of women of reproductive age and has a significant impact on women's lives, causing anemia, impaired social adaptation and professional activity. AUB-O (ovulatory dysfunction) is often caused by an excessive body mass (BM) and obesity (especially visceral). The most effective option for restoring menstrual cycle (MC) in obese women is BM reduction. There is evidence that the combination of inositols myoinositol (MI) and D-chiroinositol (DCI) has a beneficial effect on BM loss, ovulation frequency and getting pregnant in women with polycystic ovary syndrome. Aim. To study the effect of MI and DHI in a 5:1 ratio in combination with diet and exercise on the regulation of MC in overweight and obese women. Materials and methods. The study has been conducted in clinics of Moscow, Kazan and Tyumen for 20202021. It is a descriptive study assessing an efficacy of lifestyle modification (diet and exercise) plus a nutritional support with a combination of 1000 mg MI and 200 mg DCI (ratio 5:1) for 24 months in 353 women of reproductive age with AMK-O and overweight or obesity. Efficacy criteria include: MC regularity, BM index (BMI), waist circumference (WC), levels of serum glucose, free testosterone, follicle-stimulating hormone, luteinizing hormone. Results. The study showed a significant shortening of MC to its physiological duration 3112.04 days (vs 4419.51 days at the 1st visit; p=0.001), a decrease in the rate of heavy bloody vaginal discharge by 2.57 times (p=0.001), an increase in the rate of moderate bloody vaginal discharge by 1,62 times (p=0.001), an increase in the proportion of patients with regular MC by 2.69 times (p=0.001). These changes were accompanied by a decrease in BM (-3 kg; p=0.001), a decrease in WC (-2.5 cm; p=0.001). Laboratory tests revealed a decrease in serum glucose (-1.3 mmol/L; p0.05), free testosterone (-0.4 pg/L; p0.05), luteinizing hormone (-0.8 mIU/ml; p0.05), and an increase in follicle-stimulating hormone (+0.1 mIU/ml; p0.05) levels. Conclusion. The results obtained (a decrease in BM, a decrease in BMI, WC, as well as MC restoration; p0.05) make it possible to recommend Dikirogen containing MI and DCI in a 5:1 ratio as a part of comprehensive therapy for overweight and obese women with AUB-O.

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FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age

International Journal of Gynecology & Obstetrics ◽

10.1016/j.ijgo.2010.11.011 ◽

2011 ◽

Vol 113 (1) ◽

pp. 3-13 ◽

Cited By ~ 529

Author(s):

Malcolm G. Munro ◽

Hilary O.D. Critchley ◽

Michael S. Broder ◽

Ian S. Fraser ◽

Keyword(s):

Classification System ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Figo Classification

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Determination of Clinico-epidemiological Profile of Abnormal Uterine Bleeding among Women of Reproductive Age Group

10.9734/bpi/rdmmr/v5/4917f ◽

2021 ◽

pp. 156-163

Author(s):

Neetu Singh ◽

Mariyam Faruqi ◽

Yashodhara Pradeep ◽

Shweta Bhatia

Keyword(s):

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Reproductive Age ◽

Age Group ◽

Women Of Reproductive Age ◽

Epidemiological Profile ◽

Reproductive Age Group

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The Anemia Syndrome in Contemporary Women: an Unsolved Worldwide Problem. A Therapeutic Approach

Doctor Ru ◽

10.31550/1727-2378-2020-19-8-20-24 ◽

2020 ◽

Vol 19 (8) ◽

pp. 20-24

Author(s):

V.E. Radzinsky ◽

◽

A.V. Solovyeva ◽

N.G. Fedotov ◽

◽

...

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anemia ◽

Ferric Hydroxide ◽

Abnormal Uterine Bleeding ◽

First Trimester ◽

Uterine Bleeding ◽

Reproductive Age ◽

Deficiency Anemia ◽

Women Of Reproductive Age

Objective of the Review: To set forth the frequency and prevalence of the anemia syndrome in non-pregnant and pregnant women and approaches to treating this disorder. Key Points: Anemia syndrome is the most common health problem in contemporary women. The leading cause of iron deficiency in women of reproductive age is abnormal uterine bleeding (AUB). Anemia in women significantly reduces their ability to work and quality of life, and increases the rates and severity of complications in pregnant women and parturients. It is also a significant contributor to maternal mortality and fetal and neonatal morbidity. Treating anemia in pregnant women presents certain challenges. In the period between the first trimester and delivery, there is an 8-fold increase in the requirement for iron; therefore, hemoglobin levels return to normal slowly. The active ingredient of Ferrum Lek is a ferric hydroxide polymaltose complex, which is as effective as medications containing ferrous sulfate, but is significantly better tolerated by patients and easier to use. The active transport of iron allows its controlled absorption from the polymaltose complex, minimizing the risk of an increase in serum levels of iron not bound to transferrin. This ensures that this medication is very safe and eliminates the risk of overdose or poisoning. Conclusion: Anemia syndrome is the most common type of homeostatic imbalance in women of reproductive age. It most often results from frequent and abundant uterine bleeding (AUB). Therefore, an obstetrician-gynecologist plays the leading role in identifying menstrual disorders and choosing therapies to reduce blood loss. A gynecologist will also work with an internist (hematologist) in treating iron deficiency anemia. Keywords: anemia syndrome, iron deficiency anemia, abnormal uterine bleeding, ferric hydroxide polymaltose complex.

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