Dysfunctional uterine bleeding(DUB)

Dysfunctional uterine bleeding (DUB) is an abnormal bleeding from the vagina that is due to changes in hormonal level.

Dysfunctional uterine bleeding is an abnormal genital tract bleeding based in the uterus and found in the absence of demonstrable structural or organic pathology. It is usually due to hormonal disturbances, reduced levels of progesterone cause low levels of pg2 alpha and causes menorrhagia, increased levels of tissue plasminogen activator leads to more fibrinolysis.

Age/Sex prevalence of dysfunctional uterine bleeding

Females are more prone to develop DUB as it is a disease related to the female genital tract.
Most commonly females of older age or after 35 years of age are affected.

Races affected by Dysfunctional uterine bleeding(DUB)

Women of any race can be affected by DUB.

Causes of dysfunctional uterine bleeding(DUB)

Every woman’s menstrual cycle, or period, is different. On average, a woman’s period occurs every 28 days. Most women have cycles between 24 and 34 days apart. It usually lasts 4 – 7 days.

Young girls may get their periods anywhere from 21 to 45 days or more apart. Women in their 40s will often notice their period occurring less often.

About every month, the levels of female hormones in a woman’s body rise and fall. Estrogen and progesterone are two very important hormones. These hormones play an important role in ovulation, the time when the ovaries release an egg.

Dysfunctional uterine bleeding (DUB) 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.

Dysfunctional uterine bleeding sign and symptoms

Symptoms of dysfunctional uterine bleeding may include:

•Bleeding or spotting from the vagina between periods
•Periods that occur less than 28 days apart (more common) or more than 35 days apart
•Time between periods changes each month
•Heavier bleeding (such as passing large clots, needing to change protection during the night, soaking through a sanitary pad or tampon every hour for 2 – 3 hours in a row)
•Bleeding lasts for more days than normal or for more than 7 days

Other symptoms caused by changes in hormone levels may include:

•Excessive growth of body hair in a male pattern (hirsutism)
•Hot flashes
•Mood swings
•Tenderness and dryness of the vagina

A woman may feel tired or have fatigue if she is losing too much blood over time. This is a symptom of anemia.

Investigations for dysfunctional uterine bleeding(DUB)

The health care provider will do a pelvic examination and may perform a Pap smear. Tests that may be done include:

•Complete blood count (CBC)
•Blood clotting profile
•Hormone tests

FSH
LH
Male hormone (androgen) levels
Prolactin
Progesterone

•Pregnancy test
•Thyroid function tests
•Pap smear and culture to look for infection

Your health care provider may recommend the following:

•Biopsy to look for infection, precancer, or cancer, or to help decide on hormone treatment
•Hysteroscopy, performed in the doctor’s office, to look into the uterus through the vagina.
•Transvaginal ultrasound to look for problems in the uterus or pelvis.

Treatment for dysfunctional uterine bleeding(DUB)

Young women within a few years of their first period are often not treated unless symptoms are very severe, such as heavy blood loss causing anemia.

In other women, the goal of treatment is to control the menstrual cycle. Treatment may include:

•Birth control pills or progesterone only pills
•Intrauterine device (IUD) that releases the hormone progestin
•Ibuprofen or naproxen is taken just before the period starts

The 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:

•Endometrial ablation or resection to destroy or remove the lining of the uterus
•Hysterectomy to remove the uterus
•D and C to remove polyps and diagnose certain conditions

Prognosis of dysfunctional uterine bleeding(DUB)

Hormone therapy usually relieves symptoms. Treatment may not be needed if you do not develop anemia due to blood loss.

Complications of dysfunctional uterine bleeding(DUB)

•Infertility (inability to get pregnant)
•Severe anemia due to a lot of blood loss over time
•Increased risk for endometrial cancer

Differential diagnosis of dysfunctional uterine bleeding(DUB)

• Ectopic pregnancy
• Endometrial carcinoma
• Endometriosis
• Endometritis
• Hyperprolactinemia
• Hyperthyroidism
• Hypothyroidism
• Uterine cancer
• Vaginitis
• Ovarian polycystic disease
• Adnexal tumors
• Cervical cancers
• Abortion
• Cervicitis
• Genitourinary infections

Homoeopathic treatment for dysfunctional uterine bleeding(DUB)

Thlaspi bursae

•Metrorrhagia too frequent and copious menses.
•Haemorrhage with violent uterine colic.
•Sore pain in the womb on rising.
•Every alternate period very profuse.
•Patient scarcely recovers from one period before another begins.
•Leucorrhoea before and after menses which is bloody, dark, offensive stains indelibly.

Sabina

•Menses profuse and bright.
•Well indicated medicine for threatened miscarriage.
•Discharge of blood between periods, with sexual excitement.
•Menorrhagia in women who aborted readily.
•Hemorrhage from uterus which is partly clotted worse from least motion.
•This medicine helps to expel moles the room uterus.

Vinca minor

•Well indicated medicine for females having complaint of excessive menstruation with great weakness.
•Hemorrhages from fibroids.
•Passive uterine hemorrhages.
•Menorrhagia with continuous flow particularly at climacteric age.

Kreosotum 

•Well indicated medicine for menstrual flow intermits.
•Flow ceases on sitting or walking, reappears on lying.
•Pain is worse after menses.
•Hemorrhage after coition.
•Burning and soreness in external and internal parts.
•During menses hearing difficult.

Carbo animalis

•Menses too early, frequent long lasting followed by great exhaustion, so weak can hardly speak.
•Menses flow only in morning.
•Patient complains of burning in vagina and labia.
•Cancer of uterus, burning down thighs.
•Lochia offensive.

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