scholarly journals Recent trends in managing abnormal uterine bleeding

2021 ◽  
Vol 10 (4) ◽  
pp. 1742
Author(s):  
Shruthi Ananthula ◽  
Ushadevi Gopalan ◽  
Sivan Kumar Kumarapillai
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Major Surgery ◽  
High Morbidity ◽  
Management Options ◽  
Mesh Terms

Abnormal uterine bleeding is one of the most common problems among women of reproductive age. It is an important health care problem and may cause physiological as well as psycological stress impairing the quality of life. The aim of this review was to present various management options for women suffering from menorrhagia. An extensive electronic literature search was done using search engines like PubMed and Google scholar using the mesh terms/ key words like “abnormal uterine bleeding, menorrhagia, medical management, hysterectomy” to identify trials and reviews on management of abnormal uterine bleeding. Various pharmacological and surgical treatment options are available, among medical therapy Tranexamic acid being most effective. Second-generation endometrial ablation techniques are effective and safe alternatives compared to first-generation devices. Hysterectomy should be considered as a last resort in management of AUB as this major surgery is associated with high morbidity and mortality rates. Thus role of clinician is to counsel every women and provide full information regarding both medical as well as surgical treatment modalities available and facilitate them in making an appropriate choice.

scholarly journals Management of endometriosis-related infertility: Considerations and treatment options

2020 ◽  
Vol 47 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Dayong Lee ◽  
Seul Ki Kim ◽  
Jung Ryeol Lee ◽  
Byung Chul Jee
Keyword(s):  
Surgical Treatment ◽  
Ovarian Reserve ◽  
Intrauterine Insemination ◽  
Treatment Options ◽  
Oocyte Retrieval ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Inflammatory Reactions ◽  
Risk Of Cancer

Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as <i>in vitro</i> fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.

scholarly journals Biomarkers in abnormal uterine bleeding†

2018 ◽  
Vol 101 (6) ◽  
pp. 1155-1166 ◽  
Author(s):  
Rohan Chodankar ◽  
Hilary O D Critchley
Keyword(s):  
Standard Treatment ◽  
Treatment Options ◽  
Unmet Need ◽  
Treatment Strategies ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Major Surgery ◽  
Clinical Area ◽  
Tailored Approach

Abstract Abnormal uterine bleeding (AUB) is an extremely common problem and represents a clinical area of unmet need. It has clinical implications and a high cost for the healthcare system. The PALM-COEIN acronym proposed by FIGO may be used as a foundation of care; it improves the understanding of the causes of AUB, and in doing so facilitates effective history taking, examination, investigations, and management. Heavy menstrual bleeding, a subset of AUB, is a subjective diagnosis and should be managed in the context of improving the woman's quality of life. Available evidence suggests that there is poor satisfaction with standard treatment options often resulting in women opting for major surgery such as hysterectomy. Such women would benefit from a tailored approach, both for diagnosis and treatment, highlighting the deficiency of biomarkers in this area. This article focuses on the causes of AUB as per the PALM-COEIN acronym, the researched biomarkers in this area, and the potential pathogenetic mechanisms. In the future, these approaches may improve our understanding of AUB, thereby enabling us to direct women to most suitable current treatments and tailor investigative and treatment strategies to ensure best outcomes, in keeping with the principles of personalized or precision medicine.

scholarly journals Abnormal uterine bleeding in adolescence

2018 ◽  
Vol 7 (4) ◽  
pp. 1296 ◽  
Author(s):  
Sunita Samal ◽  
Ashwini Vishalakshi
Keyword(s):  
Treatment Options ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Treatment Modalities ◽  
Dysfunctional Uterine Bleeding ◽  
Gnrh Analogues ◽  
Combined Oral Contraceptives ◽  
Common Cause ◽  
Inflammatory Drugs ◽  
The One

Abnormal uterine bleeding (AUB), which is defined as excessively heavy, prolonged and/or frequent bleeding of uterine origin, is a frequent cause of visits to the Emergency Department and/or health care provider. While there are many etiologies of AUB, the one most likely among otherwise healthy adolescents is dysfunctional uterine bleeding (DUB), which is characterizing any AUB when all possible underlying pathologic causes have been previously excluded. The most common cause of DUB in adolescence is anovulation, which is very frequent in the first 2-3 post-menarchal years and is associated with immaturity of the hypothalamic-pituitary-ovarian axis. Management of AUB is based on the underlying etiology and the severity of the bleeding and primary goals are prevention of complications, such as anemia and reestablishment of regular cyclical bleeding, while the management of DUB can in part be directed by the amount of flow, the degree of associated anemia, as well as patient and family comfort with different treatment modalities. Treatment options for DUB are: combined oral contraceptives (COCs), progestogens, non-steroidal anti-inflammatory drugs (NSAIDs), tranexamic acid (anti-fibrinolytic), GnRH analogues, Danazol and Levonorgestrel releasing intra uterine system (LNG IUS).

Overview of Treatment Options for Critical Limb Ischaemia Patients

2011 ◽  
Vol 7 (1) ◽  
pp. 51 ◽  
Author(s):  
Frederic Baumann ◽  
Nicolas Diehm ◽  
◽  
Keyword(s):  
Treatment Options ◽  
Critical Limb Ischaemia ◽  
Treatment Modalities ◽  
High Morbidity ◽  
Limb Ischaemia ◽  
Arterial Revascularisation ◽  
Planning Treatment ◽  
Treatment Concepts ◽  
Peripheral Arterial ◽  
Renal Origin

Patients with critical limb ischaemia (CLI) constitute a subgroup of patients with particularly severe peripheral arterial occlusive disease (PAD). Treatment modalities for these patients that often exhibit multilevel lesions and severe vascular calcifications are complicated due to multiple comorbidities, i.e. of cardiac and vascular but also of renal origin. These need to be taken into consideration while planning treatment options. Although CLI is associated with considerably high morbidity and mortality rates, the clinical outcome of patients being subjected to revascularisation has improved substantially in recent years. This is mainly due to improved secondary prevention strategies as well as dedicated endovascular innovations for this most challenging patient cohort. The aim of this article is to provide a discussion of the contemporary treatment concepts for CLI patients with a focus on arterial revascularisation.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

scholarly journals Thyroid abnormality in abnormal uterine bleeding: an observational study from Medical College in Eastern UP, India

2017 ◽  
Vol 7 (1) ◽  
pp. 308
Author(s):  
Prachi Singh ◽  
Prashant Dubey ◽  
Shweta Yadav ◽  
Sachin Singh Yadav
Keyword(s):  
Observational Study ◽  
Thyroid Function ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Thyroid Function Tests ◽  
Cross Sectional ◽  
Medical College ◽  
Hormonal Imbalance ◽  
Euthyroid Status

Background: Abnormal Uterine Bleeding (AUB) is one of the commonest gynecological complain in reproductive age group. Menstrual abnormalities are commonly seen when there is any alteration in thyroid function. Objective of present study was to investigate the prevalence of AUB and to determine the menstrual pattern in cases with thyroid dysfunction.Methods: The present cross sectional observational study was conducted Teerthankar Mahaveer Medical College and Research Center Moradabad. Total 400 cases presenting with AUB were included in the study. Routine blood test, ultrasonography and thyroid function tests were done in these cases.Results: Among all the cases presenting with menstrual abnormalities 26% had hypothyroidism and 9% have hyperthyroidism and rest had euthyroid status. Menorrhagia (45.2%) and polymenorrhoea (37.5%) were commonest menstrual abnormality seen in cases with hypothyroidism. Most cases with hyperthyroidism presented with hypomenorrhoea (27.8%).Conclusions: Thyroid function abnormality is common in cases presenting with AUB and it gets relieved in correcting hormonal imbalance.

Systemic Monotherapy Treatments for Generalized Pustular Psoriasis: A Systematic Review

2018 ◽  
Vol 22 (6) ◽  
pp. 591-601 ◽  
Author(s):  
Linghong Linda Zhou ◽  
Jorge R. Georgakopoulos ◽  
Arvin Ighani ◽  
Jensen Yeung
Keyword(s):  
Treatment Options ◽  
Treatment Algorithm ◽  
Pustular Psoriasis ◽  
Treatment Modalities ◽  
High Morbidity ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Treatment Regimens ◽  
Generalized Pustular Psoriasis ◽  
Pubmed Search

Generalized pustular psoriasis (GPP) is a rare but serious and difficult to treat cutaneous disease, with high morbidity and mortality rates. Despite the numerous treatment regimens available, the overall quality of evidence-based research is limited with a lack of an algorithmic approach available. In this review, we aim to evaluate the current level of evidence regarding the efficacy and safety/tolerability of systemic monotherapies available in the treatment of GPP. A comprehensive MEDLINE, EMBASE, and PubMed search of clinical studies examining systemic monotherapy treatment options for GPP was conducted. In total, 31 studies met eligibility criteria. Described treatment modalities included retinoids, cyclosporine, biologics, and dapsone. Despite the lack of high-quality evidence or a well-accepted treatment algorithm for GPP, systemic retinoids, cyclosporine, biologics, and dapsone are all possible first-line agents, with retinoids being one of the best-supported treatment options and biologics as an emerging therapeutic field with great potential requiring additional data. However, the final choice of treatment should be considered within the unique context of each patient.

EVALUATE THE RELATION BETWEEN THYROID DISORDERS AND ABNORMAL UTERINE BLEEDING IN REPRODUCTIVE AGE GROUP : A CROSS SECTIONAL STUDY AT ANMMCH, GAYA, BIHAR

2021 ◽  
pp. 15-16
Author(s):  
Kumari Ragini ◽  
Kumar Sourav ◽  
Lata Shukla Diwedi ◽  
Debarshi Jana
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Structural Defects ◽  
Thyroid Disorders ◽  
Thyroid Function Tests ◽  
Age Group ◽  
Reproductive Age Group

Introduction: Abnormal uterine bleeding (AUB) is a common disorder occurring in reproductive age group females. It can be understood as bleeding that occurs from the uterus outside the normal parameters and there is no structural defects in the genital tract. One of the most common association with AUB is thyroid dysfunctions. Hence this study aimed to see the incidence of thyroid related disorders in AUB and also to assess the menstrual pattern. Material and Methods: 100 women suffering from AUB who presented to OPD of Obstetrics and Gynecology department of Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar were recruited in the study. All females in 19 to 45 years of age group with abnormal uterine bleeding were included excluding those with previously known thyroid disorder, abortion history within 3 months etc. Thyroid function tests were done in all along with ultrasonography of pelvis region. Statistical analysis done. Results: The bleeding abnormality that was found in the most of the women was heavy menstrual bleeding. Women who presented with thyroid dysfunction were 33%. 23% had subclinical hypothyroidism, 6% had hypothyroidism and 4% had hyperthyroidism. Conclusion: Abnormal Uterine Bleeding has strong association with thyroid disorders. Most common type of disorder is subclinical hypothyroidism. Thus all patient of AUB must be evaluated for thyroid dysfunction

Abnormal uterine bleeding in women of reproductive age and premenopause

2020 ◽  
Vol 8_2020 ◽  
pp. 29-38
Author(s):  
Solovyeva A.V. Solovyeva ◽  
Chegus L.A. Chegus ◽  
◽  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Women Of Reproductive Age
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