Dysfunctional Uterine Bleeding (DUB)

Dysfunctional uterine bleeding (DUB) is a condition characterized by abnormal uterine bleeding that is not associated with any underlying structural or systemic disease. It is a common gynecological disorder that affects women of reproductive age.

Causes and Risk Factors

The exact cause of DUB is often unknown, but it is thought to be related to hormonal imbalances, particularly an imbalance between estrogen and progesterone. Other potential causes and risk factors include:

• Hormonal fluctuations during the menstrual cycle
• Polycystic ovary syndrome (PCOS)
• Thyroid disorders
• Stress
• Weight changes
• Certain medications, such as anticoagulants and hormone replacement therapy

Symptoms

The symptoms of DUB can vary depending on the individual and the severity of the condition. Common symptoms include:

• Irregular menstrual periods
• Heavy or prolonged menstrual bleeding
• Light or infrequent menstrual bleeding
• Spotting or bleeding between periods
• Pelvic pain or cramping

Diagnosis

The diagnosis of DUB is typically made based on a combination of medical history, physical examination, and laboratory tests. These may include:

• Pelvic exam
• Pap test
• Complete blood count (CBC) to rule out anemia
• Blood tests to check hormone levels, such as follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH)
• Ultrasound or other imaging tests to rule out underlying structural abnormalities

Treatment

The treatment of DUB depends on the severity of symptoms, medical history, and individual preferences. Options may include:

• Hormonal therapies, such as birth control pills or progesterone-only medications
• Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and bleeding
• Tranexamic acid to reduce heavy bleeding
• Lifestyle modifications, such as stress management and weight loss
• Surgical options, such as endometrial ablation or hysterectomy, in severe cases

Complications

If left untreated, DUB can lead to complications such as:

• Anemia due to heavy bleeding
• Iron deficiency
• Decreased quality of life due to symptoms and discomfort
• Increased risk of endometrial cancer in women with unopposed estrogen exposure

Prognosis

The prognosis for DUB is generally good, with most women experiencing significant improvement in symptoms with treatment. However, some women may experience persistent or recurrent symptoms, and ongoing management and monitoring may be necessary.