Conservative Management Of Abnormal Uterine Bleeding
What is Abnormal Uterine Bleeding(AUB)?
Abnormal uterine bleeding is a term referred to as menstrual blood loss in abnormal quantity, duration or schedule in a non pregnant woman.
Causes of AUB?
Ovulatory dysfunction leading to hormonal imbalance ultimately leading to endometrial hyperplasia and excessive bleeding is the main cause of DUB.it is caused by functional abnormality of Hypothalamo Pituitary Ovarian Axis.
Causes of AUB (Abnormal Uterine Bleeding)
- Polyp
- Adenomyosis
- Leiomyoma / fibroid in uterus
- Malignancy
- Coagulopathy
- Ovulatory dysfunction
- Endometrial
- Iatrogenic(Intrauterine Cu Device)
- Non classified
How to diagnose?
- A complete Gynec examination and history taking helps in identifying the cause of AUB.
- Transvaginal Sonography is a must to detect any uterine pathology , MRI pelvis may be helpful
- Endometrial / Cervical biopsy as per the need to detect simple endometrial hyperplasia or malignancy.
- Laboratory investigation to rule blood coagulopathy and other hormonal imbalance.
How to treat Abnormal Uterine Bleeding?
Treatment depends upon the cause of the bleeding.
The goal of treatment is to control bleeding, treat anemia and restore quality of life.
Management
- Conservativem
- Surgical It includes surgical removal of Polyp, fibroid or malignancy.
Conservative Management?in which patients?
Young females between the age group of 30 to 40 years who desire to keep the uterus in situ.
Oral medications
- Oral Contraceptive Pills (OCPS)
- Progestin only pills
Injectable medication: Injectable Progestin. DMPA(Depot Medroxy Acetate )
Mirena: Levonorgestrel Releasing IntraUterine Device. Advised in patients who don't desire pregnancy in near future. The life span of the device is 5 years.
