Chapter-05 Hormonally related abnormal uterine bleeding: dysfunctional uterine bleeding and exogenous hormone effects

2012 ◽  
pp. 69-80
Author(s):  
Debra Heller
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Exogenous Hormone ◽  
Dysfunctional Uterine Bleeding ◽  
Hormone Effects

A PROSPECTIVE ANALYTICAL STUDY OF PATIENTS WITH DYSFUNTIONAL UTERINE BLEEDING.

2021 ◽  
pp. 1-2
Author(s):  
Mangal Supe ◽  
Anup Arun Gundecha
Keyword(s):  
Social Life ◽  
Analytical Study ◽  
Systemic Disease ◽  
Abnormal Uterine Bleeding ◽  
Study Data ◽  
Uterine Bleeding ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Endometrial Pattern ◽  
Considerable Morbidity

Background: Dysfunctional uterine bleeding is dened as abnormal uterine bleeding not caused by any pelvic pathology, medications, pregnancy related complications or any systemic disease. It is the most common cause of abnormal uterine bleeding. It affects pubertal adolescents and perimenopausal women and is associated with considerable morbidity and affects patient’s family, personal and social life. Patient presents as menorrhagia, polymenorrhea, metrorrhagia or intermenstrual bleeding. It has great variations in endometrial patterns each deciding treatment modality. Objective: To determine frequency of various types of abnormal uterine bleeding and analyze the histopathology of endometrial curettage samples. Method: A prospective analytical study was conducted from Jan 2018 to Dec 2019 on sample of 650 patients between 20-70 years of age with symptoms of dysfunctional uterine bleeding presenting to medical college and hospital, Pimpri. Their endometrial samples were obtained by dilatation and curettage. To have a broader analysis the endometrial histopathology on hysterectomy specimens where the clinical diagnosis was DUB were also included in the study. Data obtained was tabulated and analyzed. Conclusion: The age group 31-40 and 41-50 years was the most common age group presenting with DUB. The predominant pattern of presentation was menorrhagia. The most common endometrial pattern on histopathology was proliferative type.

scholarly journals Ormeloxifene in the management of dysfunctional uterine bleeding

2018 ◽  
Vol 7 (5) ◽  
pp. 1885
Author(s):  
L. Thulasi Devi ◽  
Ravi Nimonkar
Keyword(s):  
Side Effects ◽  
Medical Management ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Uterine Bleeding ◽  
Brand Names ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Receptor Modulator ◽  
One Year

Background: Dysfunctional Uterine Bleeding (DUB), is the commonest cause of Abnormal Uterine Bleeding (AUB). It causes morbidity, anaemia, and unnecessary hysterectomies in women of fertile age group. This study attempts to study efficacy of medical management especially Selective Estrogen Receptor Modulator (SERM) namely Ormeloxefine (ORM) (Sevista®) in Perimenopausal women. Ormeloxifene was marketed in India for contraception under brand names Centron, Saheli, Choice-7, Novex and Novex-DS. It’s a benzopyran derivative also known as Centchroman which causes asynchronousity between ovulation and menstrual cycles possibly because of both estrogenic and anti-estrogenic actions. It has been known to cause delay in ovulation in clinical trials; however, majority have been unaffected. It causes delay in proliferation of endometrium thereby causing asynchronous cycles. It also improves motility of ciliary lining of Fallopian tubes thereby reducing the chances of implantation of fertilized egg.  Methods: This study is aimed at evaluation of subjective and objective stastical benefits and side effects in treatment of DUB in perimenopausal age group with ORM and commonly used 19 nortestosterone compound (progesterone); Norethisterone (NET).Results: Primary outcome were analyzed at the end of every 3 months and at the end of one year finally. Secondary outcomes of the study in each arm were also assessed. There was stastically significant increase in Hb and stastically significant decrease in ET. Data analysis was done for variables in each arm by t-test to estimate the mean, median, range P and t value for a conclusion. Differences were taken as significant when P<0.05.Conclusions: ORM is a safe, cost effective, non-steroidal, non-hormonal drug with convenient dosage and better compliance for medical management of perimenopausal DUB with minimum focal pathology. Side effects observed need more evaluation with larger sample size to be statistically significant.

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

scholarly journals Thyroid disorders in women with dysfunctional uterine bleeding

2016 ◽  
Vol 6 (12) ◽  
pp. 1018-1020
Author(s):  
S Subedi ◽  
B Banerjee ◽  
C Manisha
Keyword(s):  
Reproductive Function ◽  
Hormonal Treatment ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Dysfunctional Uterine Bleeding ◽  
Cross Sectional ◽  
Menstrual Pattern

Background: Thyroid hormones play a key role in the menstrual and reproductive function of women .It is recognized universally that menstrual disturbances may accompany clinical alteration in thyroid function and every clinician has encountered altered menstrual pattern among women suffering from thyroid disorders. The aim of this study was to find the incidence of thyroid disorders in Dysfunctional uterine bleeding and its correlation with menstrual patterns.Materials and Methods: A hospital based cross-sectional study including 75 cases with dysfunctional uterine bleeding attending the OPD of Nobel Medical College, where incidence of thyroid disorder was evaluated along with its correlation with menstrual patterns and histopathology.Results: The incidence of Gynecological OPD attendance due to abnormal uterine bleeding was 3%.and the incidence of thyroid dysfunction was 10.6% with hypothyroidism being the commonest. (9.3%). The commonest menstrual pattern found was menorrhagia/polymenorrhoea in 8 percent.Conclusion: Prevalence of hypothyroidism was more common in DUB. Thus every woman with menstrual irregularities should undergo thyroid assessment and this will ultimately avoid unnecessary intervention like misuse of hormonal treatment and hysterectomy.

scholarly journals A STUDY OF 70 CASES OF DUB

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Yogesh C. Parmar
Keyword(s):  
Low Socioeconomic Status ◽  
Social Life ◽  
Treatment Options ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Care Hospital ◽  
Dysfunctional Uterine Bleeding ◽  
Medical Disorders ◽  
Number Of Patients

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of dysfunctional  uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders. Methods: A retrospective study of randomly selected 70 cases of dysfunctional  uterine bleeding admitted during October 2006 to September 2007, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital named SSG Hospital at Vadodara. Only cases of AUB due to non-structural causes were included. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months. Results: Most common age group presenting with DUB was 40–50 years  and mostly  belonged to low socioeconomic status. Most of the women were multiparous.  Polymenorrhagia and menorrhagia was most common presentation. Size of uterus is normal in 44 patients. Dilatation and curratage was  having the cure rate of 65.6% .Maximum number of patients (85%) was treated surgically and 15% got medical treatment. Conclusions: Dysfuntional uterine bleeding (DUB) now termed as Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.   Keywords   Menorrhagia, Dysfunctional uterine bleeding,Abnormal uterine bleeding Perimenopausal women, Endometrium

scholarly journals Comparative Study of Desogestrel- Containing Oral Contraceptive and Levonorgestrel- Containing Oral Contraceptive in Dysfunctional Uterine Bleeding

2020 ◽  
Vol 11 (4) ◽  
pp. 5678-5684
Author(s):  
Swathi Suresh ◽  
Mariya Els Johny ◽  
Kiruba Shankari ◽  
Ahamed Irshath U ◽  
Yokesh M ◽  
...  
Keyword(s):  
Weight Gain ◽  
Oral Contraceptive ◽  
Side Effects ◽  
Menstrual Cycle ◽  
Blood Loss ◽  
Ethinyl Estradiol ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Dysfunctional Uterine Bleeding ◽  
Group D

Dysfunctional uterine bleeding is a type of abnormal uterine bleeding where vaginal bleeding occurs outside of the menstrual cycle in the absence of any known pelvic pathology. Dysfunctional uterine bleeding can be treated safely with hormone therapy. Combined oral contraceptives help in increased menstrual cycle regularity and decreased blood loss. In this study, a reliable drug for the dysfunctional uterine bleeding with maximum effectiveness and minimal side effects were assessed. This study was conducted on 120 cases of dysfunctional uterine bleeding. Patients who were diagnosed with dysfunctional uterine bleeding were randomly assigned into two groups. Group D and group L included patients who were given Ethinyl estradiol 0.02mg + desogestrel 0.15mg and Ethinyl estradiol 0.03mg + levonorgestrel 0.15mg respectively for the four consecutive 28- day cycles. Menstrual blood loss was assessed using the pictorial blood assessment chart (PBAC) score on 2nd and 4th months of recruitment. Side effects such as weight gain, acne and headache were assessed in both groups. This study shows 56.68% reduction in mean PBAC score in 2 months in desogestrel group whereas only 44.96% reduction in levonorgestrel group and 79.87% reduction in mean PBAC score in desogestrel group in 4 months whereas only 74.46% reduction in levonorgestrel group. Side effects like weight gain, acne and headache were more prominent in the levonorgestrel group than desogestrel group. Desogestrel containing combined oral contraceptive can be a useful and safe treatment for dysfunctional uterine bleeding.

scholarly journals An Immunohistochemical Study of Estrogen and Progesterone Receptors in Endometrium of Women with Dysfunctional Uterine Bleeding

2021 ◽  
pp. 55-65
Author(s):  
A. Kavitha ◽  
J. Thanka
Keyword(s):  
Progesterone Receptors ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Dysfunctional Uterine Bleeding ◽  
Estrogen And Progesterone Receptors ◽  
Large Numbers ◽  
Er Alpha

Abnormal Uterine Bleeding (AUB) is a common complaint that affects large numbers of women from puberty to menopause. It negatively affects health and quality of life of women affected. AUB also has an economic impact for both women and society Abnormal uterine bleeding in premenopausal women is one of the most frequent problems in gynecological practice. Although some of the cases may be due to an organic cause, over 50% of the patients undergoing hysterectomy for menorrhagia have dysfunctional uterine bleeding (DUB). To analyze the percentage and intensity of estrogen receptors (ER) and progesterone receptors (PR) in endometrium of patients with DUB. This study suggests that estrogen and progesterone receptors have an important role in etiopathogenesis of dysfunctional uterine bleeding and alteration in the morphology of endometrium such as development of endometrial hyperplasia. Women in the reproductive age who are complaining of abnormal uterine bleeding, usually have an increase in ER alpha and PR expression in their endometrium.

scholarly journals Histopathological study of endometrium in dysfunctional uterine bleeding

2018 ◽  
Vol 7 (9) ◽  
pp. 3497
Author(s):  
Malarvizhi Loganathan ◽  
Meera Krishnakumar
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Histological Change ◽  
Uterine Bleeding ◽  
Histopathological Study ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Medical College ◽  
Histopathological Studies ◽  
The Right ◽  
Secretory Endometrium

Background: This study was undertaken to study the endometrial histology in patients presenting with abnormal uterine bleeding in the absence of palpable pelvic pathology, which helps in choosing the right modality of treatment in a particular age group with a specific histological change. The study of endometrium in dysfunctional uterine bleeding was undertaken to correlate clinical presentations with histopathological studies and to correlate the distribution of histopathological findings in various age groups.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology at Govt. Dharmapuri Medical College and Hospital during the period 01.07.2017 to 31.05.2018. Patients presenting to Govt. Dharmapuri Medical College and Hospital with abnormal uterine bleeding form the material of this study. Cases have been selected by using purposive sampling technique.Results: An ovulatory cycles were more common than ovulatory cycles in all age group. However, in patients with menorrhagia and polymenorrhagia majority had secretory endometrium (ovulatory cycles).Conclusions: Majority of the patients were found in the reproduction age group with the maximum percentage in multiparous women. Menorrhagia was the commonest mode of presentation in all age group. Most of the patients with proliferative and secretory endometrium had normal sized uterus and normal looking endometrium.

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).

Sign in / Sign up

Export Citation Format

Share Document