Abnormal uterine bleeding is defined as bleeding that occurs at unexpected times or is of an atypical duration or amount. It is the most common reason for gynecologic consultation and the second most common indication for hysterectomy. In addition to its many causes, abnormal uterine uterine bleeding must be differentiated from other possible sources of bleeding, such as the urinary and gastrointestinal tracts, and the cervix and vagina.
Causes of abnormal uterine bleeding are divided into two categories:
Hormonal: Normal ovulatory cycles usually result in regular monthly periods. When ovulation does not occur (anovulation), the hormonal cycle is disrupted and unexpected bleeding can occur. Anovulatory bleeding is also called dysfunctional uterine bleeding.
Organic or Anatomic: This category includes systemic diseases that affect the ability of the body to stop bleeding such as coagulation disorders and liver disease, as well other conditions that affect the reproductive hormones such as thyroid disease. This category also includes specific abnormalities of the reproductive tract such as pregnancy-related disorders, fibroids and polyps, functional ovarian cysts, and human causes such as IUD's and estrogen supplementation.
Treament is based on the etiology of the bleeding and can consist of treatment of an underlying systemic disease, hormonal therapy, or surgical interventions such as: D&C, hysteroscopy, endometrial ablation, or hysterectomy.