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Dysfunctional Uterine Bleeding
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- This refers to uterine bleeding other than the normal menstrual period.
- D.U.B is unpredictable according to amount, onset, and duration; usually the bleeding is painless.
- It usually occurs in early menarche (in
the early years after a woman first starts having periods) and in perimenopausal women.
- It is usually caused by inner uterus (endometrium) overgrowth, due to an over production of estrogen in relation to progesterone.
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- Vaginal bleeding between menstrual periods
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- Often unknown
- Myomas (i.e., benign tumors)
- Endometritis
- Miscarriage
- Endometrial cancer
- Ovarian cancer
- Some birth control pills
- Stress
- Current illnesses
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- Complete blood count
- Sedimentation rate
- Pregnancy test
- Glucose level to rule out diabetes
- PAP smear
- Gynecologic cultures
- Imaging/procedures that may be considered:
- Pelvic ultrasound
- Hystero-salpingography (special imaging test of uterus and ovaries)
- MRI
- Hysteroscope (scope passed in through the cervix into the uterus)
- D & C
(dilation and curettage) with cervical or endometrial biopsies if they are needed(biopsy of the inner lining of the uterus)
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- Treat underlying cause if found
- Medications
- Progesterone given last 10-14 days of cycle
- Birth control pills in order to stop the bleeding
- Danazol -- severe cases
- Depo-leuprolide -- severe cases
- Nafarelin -- severe cases
- Intravenous conjugated estrogens -- severe cases
- Surgical: Endometrial ablation -- bleeding areas are treated with laser or electrical probes.
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