Back نزف رحمي شاذ Arabic Sagnat uterí anormal Catalan Hemorragia uterina disfuncional Spanish خونریزی غیرطبیعی رحم FA דימום רחמי לא תקין HE Անոմալ արգանդային արյունահոսություն HY Perdarahan uterus abnormal ID Sanguinamento uterino atipico Italian ಗರ್ಭಾಶಯದ ಅಸಹಜ ರಕ್ತಸ್ರಾವ KN 기능성 자궁출혈 Korean
| Abnormal uterine bleeding | |
|---|---|
| Other names | Atypical vaginal bleeding, dysfunctional uterine bleeding (DUB), abnormal vaginal bleeding |
| Specialty | Gynecology |
| Symptoms | Irregular, abnormally frequent, prolonged, or excessive amounts of uterine bleeding[1] |
| Complications | Iron deficiency anemia[2] |
| Causes | Ovulation problems, fibroids, lining of the uterus growing into the uterine wall, uterine polyps, underlying bleeding problems, side effects from birth control, cancer[3] |
| Diagnostic method | Based on symptoms, blood work, medical imaging, hysteroscopy[2] |
| Differential diagnosis | Ectopic pregnancy[4] |
| Treatment | Hormonal birth control, GnRH agonists, tranexamic acid, NSAIDs, surgery[1][5] |
| Frequency | Relatively common[2] |
Abnormal uterine bleeding (AUB), also known as atypical vaginal bleeding (AVB), is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long, is heavier than normal, or is irregular.[1][3] The term dysfunctional uterine bleeding was used when no underlying cause was present.[3] Vaginal bleeding during pregnancy is excluded.[3] Iron deficiency anemia may occur and quality of life may be negatively affected.[2]
The underlying causes may include ovulation problems, fibroids, the lining of the uterus growing into the uterine wall, uterine polyps, underlying bleeding problems, side effects from birth control, or cancer.[3] More than one category of causes may apply in an individual case.[3] The first step in work-up is to rule out a tumor or pregnancy.[5][3] Medical imaging or hysteroscopy may help with the diagnosis.[2]
Treatment depends on the underlying cause.[3][2] Options may include hormonal birth control, gonadotropin-releasing hormone (GnRH) agonists, tranexamic acid, NSAIDs, and surgery such as endometrial ablation or hysterectomy.[1][5] Over the course of a year, roughly 20% of reproductive-aged women self-report at least one symptom of AUB.[2]
As adenomyosis is a common disorder with a prevalence of 20-35% it is often causative related. Recent research suggests that abnormal angiogenesis is associated to conditions of adenomyosis leading to abnormal uterine bleeding.[6][7] This suggests options for therapeutic intervention with angiogenesis inhibitors.
- ^ a b c d "Abnormal Uterine Bleeding". ACOG. March 2017. Retrieved 11 September 2018.
- ^ a b c d e f g Whitaker L, Critchley HO (July 2016). "Abnormal uterine bleeding". Best Pract Res Clin Obstet Gynaecol. 34: 54–65. doi:10.1016/j.bpobgyn.2015.11.012. PMC 4970656. PMID 26803558.
- ^ a b c d e f g h Bacon JL (June 2017). "Abnormal Uterine Bleeding: Current Classification and Clinical Management". Obstetrics and Gynecology Clinics of North America. 44 (2): 179–193. doi:10.1016/j.ogc.2017.02.012. PMID 28499529.
- ^ Cite error: The named reference
Mer2018Prowas invoked but never defined (see the help page). - ^ a b c Cheong Y, Cameron IT, Critchley H (1 September 2017). "Abnormal uterine bleeding". British Medical Bulletin. 123 (1): 103–114. doi:10.1093/bmb/ldx027. PMID 28910998.
- ^ Harmsen MJ, Wong CF, Mijatovic V, Griffioen AW, Groenman F, Hehenkamp WJ, Huirne JA (September 2019). "Role of angiogenesis in adenomyosis-associated abnormal uterine bleeding and subfertility: a systematic review". Human Reproduction Update. 25 (5): 647–671. doi:10.1093/humupd/dmz024. PMC 6737562. PMID 31504506.
- ^ Middelkoop MA, Don EE, Hehenkamp WJ, Polman NJ, Griffioen AW, Huirne JA (February 2023). "Angiogenesis in abnormal uterine bleeding: a narrative review". Human Reproduction Update. 29 (4): 457–485. doi:10.1093/humupd/dmad004. PMC 10320491. PMID 36857162.