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Abnormal uterine bleeding.

Janet R Albers¹, Sharon K Hull, Robert M Wesley

¹Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, Illinois 62702, USA. jalbers@siumed.edu

American Family Physician

|May 1, 2004

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Abnormal uterine bleeding diagnosis involves ruling out other causes. Management varies by patient risk, including medical options like oral contraceptives or surgical interventions such as hysterectomy.

Area of Science:

Gynecology
Family Medicine
Internal Medicine

Background:

Abnormal uterine bleeding (AUB) is a frequent complaint in family practice.
Initial evaluation aims to exclude pregnancy, medications, systemic conditions, and obvious pathology.

Purpose of the Study:

To outline diagnostic and management strategies for abnormal uterine bleeding.
To differentiate approaches based on patient age and risk factors for endometrial cancer.

Main Methods:

Systematic history, physical examination, and laboratory evaluation.
Risk stratification for endometrial cancer, guiding further investigations like endometrial biopsy, hysteroscopy, or ultrasonography.
Consideration of patient suitability for procedures like dilatation and curettage.

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Main Results:

Dysfunctional uterine bleeding is diagnosed by exclusion.
High-risk women may require endometrial biopsy; low-risk women can be assessed with transvaginal ultrasonography.
Postmenopausal bleeding management includes dilatation and curettage or alternative imaging with biopsy.

Conclusions:

Diagnostic approaches for AUB are tailored to patient demographics and risk.
Medical management includes hormonal therapies; menorrhagia responds well to NSAIDs or levonorgestrel IUDs.
Treatment options range from medical management to surgical interventions, including hysterectomy or uterus-sparing procedures.