Anovulatory uterine bleeding

The patient who seeks medical attention for abnormal vaginal bleeding represents an enormous responsibility. The physiologic systems that may be defective are numerous. If a diagnosis of dysfunctional uterine bleeding is made there must still be an investigation of the hormonal imbalance. The specific cause must be known in order to treat the patient effectively. In addition, recent scientific advances regarding possible cellular mechanisms for DUB make it imperative that the physician be aware of available tests. Certain tests may indicate the relative appropriateness of and the prognosis for a particular therapy. The treatment is via the addition of progesterone to complete the hormonal milieu. Progesterone may be administered either endogenously by ovulation induction or exogenously by oral or parenteral progestogens.