Abnormal bleeding

Dysfunctional uterine bleeding (DUB) is a common cause of abnormal uterine bleeding and its diagnosis depends upon excluding organic lesions of the reproductive tract. The workup of the patient requires a complete medical history, physical examination, studies for ovulation, and genital tissue sampling. Whereas DUB is a physiologic normal phenomenon in the early and late years of the reproductive cycle, it is a pathologic entity at other times and can result from mild emotional or physical diseases in the patient. Management requires periodic progesterone replacement, increased iron intake, and therapy for any disease that is detected. Generally, oral contraceptives are not indicated, and hysterectomy is rarely needed. If infertility is also a complaint, specific ovulation induction therapy may also be needed. Control of the bleeding abnormality is the expected therapeutic response, and failure to achieve this suggests that a specific genital organic lesion has been overlooked.