scholarly journals Dysfunctional Uterine Bleeding and its Management Strategy

2003 ◽  
Vol 40 (138) ◽  
pp. 98-106
Author(s):  
Ganesh Dangal
Keyword(s):  
Conservative Therapy ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Organic Disease ◽  
Dysfunctional Uterine Bleeding ◽  
Acute Bleeding ◽  
Teenage Girls ◽  
Reproductive Life ◽  
Uterine Curettage

Dysfunctional uterine bleeding (DUB) is a diagnosis of exclusion. An adequateexamination of the abdomen and the pelvis and uterine curettage, hysteroscopy or atleast an endometrial biopsy is essential to exclude organic disease of the uterus. Itoccurs most frequently at the extremes of menstrual life, but it can develop at anyintervening time.The objectives of treatment are to control the acute bleeding, avert future episodes,and prevent a serious long-term consequence of anovulation, endometrial cancer. Themainstay of treatment has been medical therapy although surgical intervention isrequired in some cases. If the bleeding is severe and / or recurrent or the medicaltreatment fails, re-evaluation is needed.Adolescent DUB is due to immaturity of the hypothalamus and pituitary and menstrualcycles may be anovulatory. In teenage girls organic disease is rare and DUB usuallygets resolved spontaneously. That's why they are treated expectantly and curettage isoften delayed.In the middle years of reproductive life (20-39yrs), benign organic disease is common,and curettage is usually performed to exclude complications of pregnancy and otherdisease. Conservative therapy is usually indicated, though hysterectomy may beindicated if bleeding is severe or recurrent and patient has completed her family.Perimenopausal DUB is due to the decreased number of ovarian follicles and theirincreased resistance to gonadotrophin stimulation, there is a possibility of malignancy.So, these women should always be investigated by curettage or hysteroscopy withoutdelay. Although conservative therapy may be tried as a temporizing measure,hysterectomy is often indicated.Key Words: Dysfunctional uterine bleeding, curettage, hysteroscopy, and progestogen.

scholarly journals A clinicopathological study of dysfunctional uterine bleeding

2014 ◽  
Vol 4 (8) ◽  
pp. 635-638
Author(s):  
N Katuwal ◽  
G Gurung ◽  
A Rana ◽  
A Jha
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
University Teaching ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Obstetrics And Gynaecology ◽  
Proliferative Endometrium ◽  
One Year ◽  
Complete History

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding when there is absence of organic disease of the genital tract. The objective of this study was to find out the clinical and pathological aspect of women presenting with dysfunctional uterine bleeding.Materials and Methods: A descriptive study was conducted over a period of one year from April 14th 2010 to April 13th 2011 in the Department of Obstetrics and Gynaecology and Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A complete history, clinical examination, pelvic scan, hormonal status if required and endometrial biopsy were done to diagnose dysfunctional uterine bleeding.Results: A total of 120 cases were included. The age of the patients diagnosed dysfunctional uterine bleeding were ranging from 24 -63 years. Dysfunctional uterine bleeding was most common in the age group 40-44 yrs (30%) followed by 45-49 yrs (27.5%). Menorrhagia (41.7%) was the most common presenting sign. Majority histopathology of endometrium revealed anovulatory pattern (61.7%) followed by ovulatory (38.3%). Of the cases with an anovulatory pattern 48.6% was proliferative endometrium, 33.8% disordered proliferative endometrium, 6.8%atrophic, 5.4% weakly proliferative and 2.7% each of simple hyperplasia without atypia and complex hyperplasia with atypia. All cases with ovulatory pattern showed secretory endometrium.Conclusion: Dysfunctional uterine bleeding was the most common in the perimenopausal age group and chiefly in the form of an anovulatory endometrium. . Histopathological evaluation of endometrium helps exclude the local causes and establishes the diagnosis of dysfunctional uterine bleeding, its types, and clinical correlation to histopathological findings and finally helps to determine the mode of management.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11500 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 635-638

Comparison of Uterine Artery Blood Flow Parameters in Women with Dysfunctional Uterine Bleeding, Fibroids and Healthy Controls

BMUS Bulletin ◽  
1997 ◽  
Vol 5 (2) ◽  
pp. 25-26 ◽  
Author(s):  
Kalpani P Lakhani ◽  
Paul Hardiman
Keyword(s):  
Blood Flow ◽  
Vascular Resistance ◽  
Ultrasound Examination ◽  
Resistance Index ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Prospective Clinical Study ◽  
Healthy Controls ◽  
Dysfunctional Uterine Bleeding ◽  
Significant Difference

Objective To assess uterine vascular resistance in women with dysfunctional uterine bleeding (DUB) and to compare parameters of blood flow in women with menorrhagia due to uterine fibroids and healthy controls Design Longitudinal, prospective clinical study. Materials and methods Premenopausal women referred to the gynaecology department with a subjective complaint of menorrhagia. The subjects were 24 women with DUB (mean age 38.8 years; normal ultrasound, hysteroscopy and endometrial biopsy), 16 women (mean age 42.8 years) with at least one fibroid greater than 2.0cm on ultrasound examination and 18 healthy controls (mean age 37.3 years; no evidence of menstrual irregularity). None was taking any hormonal contraception or other medication which could influence vascular resistance. Ultrasound examination was performed using an ALOKA SSD 650 with a 5MHz transvaginal probe. Scans were performed on day 4 or 5 of menstrual cycle using pulsed Doppler ultrasound. Uterine vascular resistance was assessed on both sides using pulsatility index (PI) and resistance index (RI). Results No significant difference in the PI or RI values was observed in women with DUB as compared to age matched healthy controls. Both PI and RI were significantly lower in women with menorrhagia associated with fibroids when compared with healthy controls. Conclusions The results of this study demonstrated significant alteration in uterine vascular resistance in women with fibroids compared to women with DUB.

scholarly journals Perdarahan uterus abnormal - menoragia pada masa remaja

2016 ◽  
Vol 8 (3) ◽  
Author(s):  
John J. E. Wantania
Keyword(s):  
Human Growth ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Acute Bleeding ◽  
Menstrual Cycles ◽  
Human Growth And Development ◽  
Age Of Menarche

Abstract: WHO identifies adolescence as a period in human growth and development that occurs after childhood and before adulthood from age 10 to 19 years. Two large studies have shown that a greater increase in BMI in childhood is associated with earlier onset of puberty. In general, the age of menarche ranges relatively stable from 11 to 14 years with a median of 12.43 years. The average of menstrual cycle interval is 32.3 days in the first reproduction year. After that, the interval of menstrual cycles generally ranges from 21 to 45 days. Duration of menstruation is 7 days or less. The use of tampons or pads are generally three to six pieces per day. Abnormal uterine bleeding (AUB) is defined as a significant change in the pattern of menstruation or the volume of blood discharge, and is the most common complaint in women. In early adolescence, 75% of adolescents experience abnormal uterine bleeding. Heavy menstrual bleeding (HMB) as well as heavy and prolonged menstrual bleeding (HPMB) is the preferred term for excessive menstrual bleeding. Medical treatment is performed as the initial treatment as long as there is no contraindication. When the acute bleeding has been handled, it is recommended to arrange a transition in the long-term treatmentKeywords: menstruation, teens, abnormal uterine bleeding (AUB)Abstrak: WHO mengidentifikasi remaja sebagai periode pada pertumbuhan manusia dan perkembangan yang terjadi setelah masa kanak-kanak dan sebelum dewasa, dari umur 10 sampai 19 tahun. Dua studi besar telah membuktikan bahwa peningkatan IMT yang lebih besar pada masa kanak-kanak berhubungan dengan onset pubertas yang lebih awal. Usia menarche umumnya relatif stabil berkisar antara 11 dan 14 tahun dengan median 12,43 tahun. Interval siklus rata-rata ialah 32,3 hari pada tahun reproduksi pertama dan interval siklus mentruasi umumnya 21-45 hari. Lama menstruasi ialah 7 hari atau kurang. Penggunaan tampon atau pembalut umumnya tiga sampai enam buah per hari. Perdarahan uterus abnormal (PUA) adalah perubahan signifikan pada pola atau volume darah menstruasi dan merupakan hal yang paling banyak dikeluhkan oleh wanita. Pada awal usia remaja, 75% remaja mengalami keluhan PUA. Perdarahan haid berat (heavy menstrual bleeding) dan perdarahan haid berat dan memanjang (heavy and prolonged menstrual bleeding) ialah istilah yang lebih sering digunakan untuk perdarahan haid yang berlebihan. Penanganan medis menjadi terapi awal bila tidak ada kontrindikasi. Bila perdarahan akut sudah ditangani, direkomendasikan untuk melakukan transisi pada penanganan jangka panjang.Kata kunci: menstruasi, remaja, perdarahan uterus abnormal (PUA)

scholarly journals Extrapulmonary uterine lymphangioleiomyomatosis (LAM) and dysfunctional uterine bleeding: the first presentation of LAM in a tuberous sclerosis complex patient

2019 ◽  
Vol 12 (2) ◽  
pp. e226358
Author(s):  
Lucy Grant ◽  
Saliya Chipwete ◽  
San Soo Hoo ◽  
Anjali Bhatnagar
Keyword(s):  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Strong Association ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Uterine Leiomyosarcoma ◽  
Childbearing Age ◽  
Dysfunctional Uterine Bleeding ◽  
Cross Sectional ◽  
Tuberous Sclerosis Complex Patient

Lymphangioleiomyomatosis (LAM) is a rare disease that typically affects women of childbearing age. It most commonly affects the lungs (P-LAM) but can occasionally occur in extra-pulmonary sites (E-LAM). There is a strong association between LAM and the tuberous sclerosis complex (TSC). We report a case of a 42-year-old female TSC sufferer who presented with dysfunctional uterine bleeding. She was not known to have LAM. An endometrial biopsy revealed a spindled-cell lesion suspicious of leiomyosarcoma, which correlated with cross-sectional imaging. She underwent a hysterectomy that showed a bizarre (symplastic) leiomyomatous endometrial polyp with background uterine LAM. We discuss the clinical and pathological implications of this unusual case of E-LAM and the importance of clinicopathological correlation in TSC sufferers. The association of uterine LAM with TSC is important and LAM should be considered as a differential of dysfunctional uterine bleeding and a benign mimic to uterine leiomyosarcoma in patients with TSC.

scholarly journals Histopathological Study of Endometrium in Patients of Perimenopausal Age Group in a tertiary care Hospital in West Bengal

2021 ◽  
Vol 12 (9) ◽  
pp. 84-87
Author(s):  
Nabanita Chakraborty ◽  
Rajasri Chunder ◽  
Barnali Mukherjee ◽  
Soham Chakraborty
Keyword(s):  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Histological Change ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Histopathological Study ◽  
Care Hospital ◽  
Age Group ◽  
Histological Changes ◽  
Reproductive Life

Background: Menopause is an important event in women’s life and it marks the end of a woman`s reproductive life. Perimenopause is the interval in which a woman`s body makes a natural shift from regular cycles of ovulation & menstruation to irregular cycles and various forms of abnormal uterine bleeding. Dysfunctional uterine bleeding (DUB) is a very frequent complaint from women in the perimenopausal age group. The histological diagnosis of DUB and its proper management is very essential in this age group. Aims and Objective: Primary aim of our study was to identify the spectrum of histological changes that occur in the endometrium in perimenopausal age group and to identify the demographic pattern of each histological change. Materials and Methods: Fifty-two specimens of endometrial biopsy obtained from the patients in the perimenopausal age group of 40-50 years attending the Gynaecology and Obstetrics department were studied. Results: 71.15% cases of DUB was diagnosed amongst the 52 endometrial biopsy specimens in perimenopausal age group and Secretory endometrium is most common histological pattern. Conclusion: This study reflects a spectrum of endometrial histology present during perimenopausal age. This study has  also highlighted the correlation of endometrial histology with final diagnoses of the patients, and this may help in diagnosis and treatment of gynaecological diseases of this specific age group in future.

scholarly journals Efficacy of Intrauterine Lidocaine Instillation in Reducing Pain during Endometrial Biopsy by Novak

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Sawanya Benchahong ◽  
Athita Chanthasenanont ◽  
Densak Pongrojpaw ◽  
Junya Pattaraarchachai ◽  
Kornkarn Bhamarapravatana ◽  
...  
Keyword(s):  
Normal Saline ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Physician Satisfaction ◽  
University Hospital ◽  
Saline Control ◽  
Control Group ◽  
Lidocaine Group ◽  
Uterine Curettage

Abnormal uterine bleeding in women aged 35 years or over is an important clinical sign of many gynecological conditions. The diagnoses of these conditions require the pathological report of the endometrial tissue. Outpatient-based endometrial biopsy is an excellent option compared to standard fractional uterine curettage or hysteroscopy with endometrial biopsy in providing a definite diagnosis for abnormal uterine bleeding as it is less painful and does not require high potency anesthesia. This study evaluates the effect of intrauterine lidocaine on the patient’s pain score during endometrial biopsy by the Novak curette. We included patients aged 35 years or more who had abnormal uterine bleeding between December 2016 and March 2018. The study was conducted at Thammasat University Hospital, Pathum Thani, Thailand. 250 patients were randomly allocated to either receive intrauterine lidocaine (study group) or normal saline (control group). Assessment of pain severity was evaluated using a visual analogue scale (VAS) score at 6 time-points, namely, before performing the procedure, when grasping the cervix by the tenaculum, during the intrauterine instillation of lidocaine or normal saline, during the uterine curettage, and then 15 minutes and 2 hours after the procedure. This study showed that there was significant pain reduction in patients who received intrauterine instillation of lidocaine compared to placebo, during uterine curettage, as well as 15 minutes and 2 hours after procedure (p<0.0001). Patient satisfaction was not significantly different between the two groups, while physician satisfaction significantly improved in the lidocaine group. Serious complications were not found during this study. (This research project had been approved for registration at Thai Clinical Trials Registry. TCTR identification number is TCTR20161031003.)

scholarly journals Histopathological analysis of endometrial biopsies in dysfunctional uterine bleeding

2016 ◽  
Vol 6 (11) ◽  
pp. 910-913
Author(s):  
N Nepal ◽  
PK Chaudhary ◽  
N Mainali
Keyword(s):  
Malignant Lesion ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Histopathological Analysis ◽  
Dysfunctional Uterine Bleeding ◽  
Cross Sectional ◽  
Medical College ◽  
Proliferative Endometrium ◽  
Post Menopausal

Background: It is estimated that 9-30% of women of reproductive age suffer from menorrhagia. Because most cases are associated with anovulatory menstrual cycles, adolescent and perimenopausal women are particularly vulnerable to this particular condition. The aim of this study was to evaluate the histopathological pattern of endometrial biopsy from patients presenting with dysfunctional uterine bleeding.Materials and Methods: This is a cross-sectional observational study done in Nobel Medical College, Biratnagar, Nepal for a period of three years from June 2012 to June 2015. All the patients presenting with dysfunctional uterine bleeding and who underwent endometrial biopsy were included in this study. Distribution of various histopathological patterns was observed in the different age groups.Results: A total of 300 cases were included in my study. The commonest pattern in these patients was proliferative endometrium 61 (%). The commonest pathology was simple cystic hyperplasia (13.3%). Other patterns identified were secretory endometrium, chronic endometritis and pill endometrium. Malignant lesion comprised of 8 (2.7%) of patients and the majority was in >50 years followed by in between 41-50 years of age. Atrophic endometrium was the commonest finding in post menopausal bleeding, comprising of 11 cases (3.6%), followed by endometrial carcinoma of 8 cases (2.7%).Conclusion: As observed from the study, there is an age specific association of endometrial bleeding, with highest incidence in perimenopausal age group. Hence, dilatation and curettage is helpful for diagnosis, to assess therapeutic response and to know the pathological incidence of organic lesions in cases of dysfunctional uterine bleeding. 

Risk Categories for Abnormal Endometrial Biopsy in Dysfunctional Uterine Bleeding

Journal SOGC ◽  
2000 ◽  
Vol 22 (4) ◽  
pp. 265-269
Author(s):  
Scott A. Farrell ◽  
Sheri-Lee Samson ◽  
Stephanie Ash ◽  
Gordon Flowerdew ◽  
Pantelis Andreou
Keyword(s):  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Dysfunctional Uterine Bleeding ◽  
Risk Categories
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