Dysfunctional uterine bleeding

Dysfunctional uterine bleeding (DUB) affects about 5% of menstruating women. yet the majority of medical practitioners who manage the problem do not adequately understand the underlying pathophysiology nor the principles involved in appropriate management.

This article is an attempt to provide a brief overview of the problem and to review the current information regarding the diagnosis, incidence, cause and management of DUB.

The majority of cases of DUB occur in the 5-10 years before the menopause or after the menarche, when the ovaries are in an unstable responsive state. Hormonal dysfunction is responsible for most cases of DUB and the condition will usually respond to appropriate hormonal therapy. In those instances where hormones are not a viable option or have not controlled the problem, then prostaglandin inhibitors or the use of tranexamic acid may allow short term relief from excessive bleeding. Surgery by endometrial ablation of hysterectomy should only be considered when all other options have failed.