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Dysfunctional Uterine Bleeding (DUB)

Dysfunctional Uterine Bleeding (DUB), also referred to as abnormal uterine bleeding, is any unusual or heavy vaginal bleeding unrelated to normal menstruation. Normal menstruation occurs every 21 to 35 days in women.

Causes of Dysfunctional Uterine Bleeding

Some causes include:

  • Hormonal imbalance
  • Certain medications such as birth control pills
  • Certain medical conditions such as polycystic ovary syndrome (PCOS), endometriosis, or sexually transmitted diseases such as gonorrhea and chlamydia
  • Uterine polyps or fibroids (an abnormal outgrowth of tissues or tumors)

Symptoms of Dysfunctional Uterine Bleeding

Symptoms include:

  • Bleeding that occurs outside the normal menstruation cycle
  • Heavy bleeding between periods
  • Spotting
  • Bleeding with large or many clots
  • Bleeding that lasts for more than 7 days or fewer than 21 days between periods

Other common symptoms include bloating, breast tenderness or pelvic pain. You should call your doctor immediately if you encounter weakness, fainting, dizziness, low blood pressure, pale skin, or soaking through a pad every hour.

Diagnosis of Dysfunctional Uterine Bleeding

Your doctor will consider your family health history as well as complete details of your menstrual cycles (dates, length, and type of bleeding). You will also have blood tests to check your hormonal levels to diagnose the cause of your bleeding. Tests such as ultrasound or biopsies may also be ordered to diagnose DUB.

Treatment for Dysfunctional Uterine Bleeding

Most cases of DUB can be treated with medications, except for a few which may require surgery.

Medications: Hormonal medications used to treat abnormal bleeding depend on whether you are planning a pregnancy and your age factor. Hormones can be given as injections, vaginal creams or through intra-uterine devices (a birth control device which is inserted into the uterus). The hormones are slowly released into the body by these means to control the abnormal bleeding. Your doctor may prescribe other medications such as anti-inflammatory drugs to reduce bleeding and infection respectively.

Surgical treatment: Your doctor will recommend surgical treatment if the bleeding is caused by polyps or fibroids. Surgery is aided by hysteroscopy, which uses a flexible tube or endoscope for visualization of the fibroids. The procedure may involve uterine artery embolization (stops blood flow to the fibroids), and myomectomy (fibroid removal). Some other procedures like endometrial ablations (removal of a thin layer of the uterine wall to reduce bleeding), may also be performed. Hysterectomy (surgical removal of the entire uterus) may be considered if all other forms of treatments have failed. You can no longer conceive after a hysterectomy.

Along with these treatments, you should take good care of yourself by eating a well-balanced diet, exercising, and getting the proper amount of sleep.

Allen OB/GYN

931 SH 121, Suite 2500, Allen, TX 75013