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Abnormal (Dysfunctional) Uterine Bleeding

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Abnormal uterine bleeding (AUB) is irregular menstrual bleeding (usually heavy, prolonged, or frequent); it is a diagnosis of exclusion after establishment of normal anatomy and the ...

DIAGNOSIS

HISTORY

  • Menstrual history

    • Onset, severity (quantified by pad/tampon use, presence and size of clots), timing of bleeding (unpredictable or episodic)

    • Menorrhagia with onset of menarche is sugg...

TREATMENT

Attempt to rule out other causes of bleeding prior to instituting therapy. 

GENERAL MEASURES

NSAIDs (naproxen sodium 500 mg BID, mefenamic acid 500 mg TID, ibuprofen 600 to 1,200 mg/day) (1)[B...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Once stable from acute management, recommend follow-up evaluation in 4 to 6 months for further evaluation (5).

  • Routine follow-up with a primary care or OB/GYN prov...

REFERENCES

1
1 Sweet MG, Schmidt-Dalton TA, Weiss PM, et al. Evaluation and management of abnormal uterine bleeding in premenopausal women. Am Fam Physician.  2012;85(1):35–43. {L-End} {L-End} ...

ADDITIONAL READING

  • Goldstein SR, Lumsden MA. Abnormal uterine bleeding in perimenopause. Climacteric.  2017;20(5):414–420. {L-End} {L-End} [View Abstract on OvidMedline]

  • Lethaby A, Cooke I, Ree...

SEE ALSO

  • Dysmenorrhea; Menorrhagia (Heavy Menstrual Bleeding)

  • Algorithm: Abnormal Uterine Bleeding

CODES

ICD10

  • N93.9 Abnormal uterine and vaginal bleeding, unspecified

  • N93.8 Other specified abnormal uterine and vaginal bleeding

  • N91.2 Amenorrhea, unspecified

  • N92.3 Ovulation bleeding

  • N92.2 Excessive menst...

CLINICAL PEARLS

  • AUB is irregular bleeding that occurs in the absence of pregnancy or pathology, making it a diagnosis of exclusion.

  • Anovulation accounts for 90% of AUB.

  • An EMB should be performed in all...

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