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How best to manage dysfunctional uterine bleeding.
David L Maness1, Avinash Reddy, Carolyn L Harraway-Smith
1Department of Family Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. dmaness@uthsc.edu
The Journal of Family Practice
|August 18, 2010
Summary
Heavy or irregular periods are common and often benign. Management includes conservative treatments for mild cases and specific interventions for moderate dysfunctional uterine bleeding (DUB).
Area of Science:
- Gynecology
- Reproductive Health
Background:
- Irregular or heavy menstrual bleeding is a frequent gynecological complaint.
- Most cases are benign and amenable to conservative management.
Purpose of the Study:
- To outline diagnostic and treatment strategies for dysfunctional uterine bleeding (DUB).
- To differentiate management approaches based on bleeding severity.
Main Methods:
- For postmenopausal women, cancer is assessed using endometrial biopsy, transvaginal ultrasound, or saline infusion sonohysterogram.
- Mild DUB is treated with nonsteroidal anti-inflammatory drugs, levonorgestrel intrauterine devices (IUDs), or danazol.
- Moderate DUB is managed with oral contraceptive pills, levonorgestrel IUDs, danazol, or tranexamic acid.
Main Results:
- Conservative management is effective for most cases of abnormal uterine bleeding.
- Specific diagnostic tools are recommended for postmenopausal women to rule out malignancy.
- Pharmacological and device-based treatments vary for mild versus moderate DUB.
Conclusions:
- Dysfunctional uterine bleeding requires a tailored approach based on severity and menopausal status.
- Early diagnosis and appropriate treatment can effectively manage abnormal uterine bleeding.
- Conservative and medical treatments are primary options for DUB management.
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