Dysfunctional uterine bleeding (DUB) is abnormal bleeding from the vagina that is due to changes in hormone levels. It is bleeding that is NOT caused by:
Your doctor will rule out other possible causes of irregular bleeding. In most women, abnormal uterine bleeding is caused by a hormone imbalance.
DUB is more common in teenagers or in women who are approaching menopause.
DUB is unpredictable. The bleeding may be very heavy or light and can occur often or randomly.
Every woman's menstrual cycle, or period, is different.
About every month, the levels of female hormones in a woman's body rise and fall. Estrogen and progesterone are two hormones that play an important role in ovulation. This is the time when the ovaries release an egg.
Dysfunctional uterine bleeding most commonly occurs when the ovaries do not release an egg. Changes in hormone levels cause your period to be later or earlier and sometimes heavier than normal.
Symptoms of dysfunctional uterine bleeding may include:
Other symptoms caused by changes in hormone levels may include:
A woman may feel tired or fatigued if she is loses too much blood over time. This is a symptom of anemia.
Your health care provider will do a pelvic exam and may do a Pap test. Other tests that may be done include:
Your provider may recommend the following:
Young women up to age 18 may be treated with low-dose combination birth control pills.
In other women, treatment may include one or more of the following:
Women over age 40 and older may have the option to receive cyclic progestin or cyclic hormone therapy.
A health care provider may recommend iron supplements for women with anemia.
If you want to get pregnant, you may be given medication to stimulate ovulation.
Women with severe symptoms that do not get better with other treatments may consider the following procedures if they no longer want to have children:
Hormone therapy usually relieves symptoms. Treatment may not be needed if you do not develop anemia due to blood loss.
Complications that may occur:
Call your health care provider if you have unusual vaginal bleeding.
Anovulatory bleeding; Bleeding - dysfunctional uterine; DUB; Abnormal uterine bleeding-hormonal; Menorrhagia - dysfunctional; Polymenorrhea - dysfunctional; Metrorrhagia - dysfunctional
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Middleton LJ, Champaneria R, Daniels JP, Bhattacharya S, Cooper KG, Hilken NH, et al. Hysterectomy, endometrial destruction, and levonorgestrel releasing intrauterine system (Mirena) for heavy menstrual bleeding: systematic review and meta-analysis of data from individual patients. BMJ. 2010 Aug 16;341:c3929. PMID: 20713583 Available at: www.ncbi.nlm.nih.gov/pubmed/20713583.
Updated by: Irina Burd, MD, PhD, Assistant Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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