Abnormal uterine bleeding: The well-known and the hidden face

Area of Science:

• Gynecology
• Reproductive Medicine
• Pathophysiology of Menstruation

Background:

• Abnormal uterine bleeding (AUB) presents as irregular, heavy, or prolonged uterine bleeding in women of reproductive age.
• Menstruation involves complex endometrial processes resembling inflammation, yet menstrual cessation mechanisms remain unclear.
• AUB significantly impacts women's well-being and quality of life.

Purpose of the Study:

• To review the causes, diagnostic methods, and management strategies for abnormal uterine bleeding.
• To highlight the importance of timely diagnosis and treatment for AUB.
• To emphasize the need for further research into AUB treatments.

Main Methods:

• Review of current literature on abnormal uterine bleeding.
• Discussion of diagnostic tools including transvaginal ultrasound, saline infusion sonohysterography, and hysteroscopy.
• Overview of medical (antifibrinolytics, progestins, GnRH analogs) and surgical management options.

Main Results:

• AUB can stem from structural causes (polyps, adenomyosis, leiomyomas) or non-structural factors (coagulopathy, ovulatory dysfunction).
• Hysteroscopy with biopsy is the gold standard for definitive AUB diagnosis.
• Various medical and surgical treatments exist, each with specific applications and limitations.

Conclusions:

• Effective management of AUB requires addressing the underlying cause and regulating bleeding patterns.
• Policymakers should prioritize access to diagnostic tools and treatments to reduce delays and complications.
• Further research is needed to evaluate the long-term efficacy of AUB interventions.