abnormal bleeding with no organic cause (diagnosis of exclusion) rule out: blood dyscrasias, thyroid dysfunction, malignancy, PCOD...
- abnormal bleeding with no organic cause (diagnosis of exclusion)
- rule out: blood dyscrasias, thyroid dysfunction, malignancy, PCOD,endometriosis, PID, fibroids, unopposed estrogen, or polyps
Adolescent Age Group
- DUB due to immature hypothalamus with irregular LH, FSH, estrogen and progesterone pattern
Reproductive Age Group
- DUB due to an increase or decrease in progesterone level
Perimenopausal Age Group
- DUB due to increased ovarian resistance to LH and FSH
Treatment
- if anemic, iron supplement
- mild DUB
- BCP 1 tab tid for 10 days then 1 tab od for 4-6 months or
- medroxyprogesterone acetate (Provera) 5-10 mg od on first 10-14 days of each month
- severe DUB
- replace fluid losses
- medroxyprogesterone acetate (Provera) 10 mg for next 7-10 days
- acute, severe DUB: estrogen (Premarin) 25 mg IV q4-6h
- surgical
- endometrial biopsy (for diagnosis)
- D&C
- endometrial ablation after pretreatment with danazol or GnRH agonists
- hysterectomy
Mid-Cycle Spotting
- may be physiologic due to mid-cycle fall of estradiol
Premenstrual Spotting
- may be due to progesterone deficiency, endometriosis, adenomyosis and fibroids
