Abnormal Uterine Bleeding RenoWhat Is The Typical Menstrual Cycle?

The menstrual cycle usually is dated from the first day of the menstrual period until the beginning of the next period. The cycle intervals range from 24 to 35 days, and the menstrual length is 2 to 6 days.The average blood loss ranges from 20ml to 60ml.

We usually categorize abnormal bleeding patterns into those associated with ovulation and those not related to ovulation (anovulatory cycles or more commonly called dysfunctional uterine bleeding – DUB). DUB is more commonly seen early in puberty and towards menopause.

Causes Of Abnormal Uterine Bleeding

A. Ovulatory – often painful

1. Pregnancy related problems
2. Infection
3. Uterine problems – fibroids, polyps
4. Cervical problems – polyps
5. Vaginal problems
6. Ovarian tumors/cysts
7. IUD’s, hormone treatment
8. Bleeding disorders
9. Adrenal gland problems
10. Liver disease
11. Kidney disease
12. Cancer

B. Anovulatory – often painless

1. Diagnosis of exclusion
2. Anovulatory disorders – Polycystic ovarian disorder

Evaluation

1 starts with a thorough history and physical exam

2 Pap test, pelvic ultrasound, directed blood tests and biopsy of the uterine lining if indicated

14 surgical evaluation – both office and hospital

Management

15 exclude pregnancy related problems
16 evaluate for bleeding disorders and treat accordingly
17 use of hormones/ birth control pills
18 surgery
19 treatment modalities differ at different age groups

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