DYSFUNCTIONAL UTERINE BLEEDING

DEFINITION DUB is defined as a state of abnormal uterine bleeding without any clinically detectable organic, systemic and iatrogenic causes Tumour, inflammation or pregnancy is excluded

INCIDENCE 10%

TYPES OVULAR BLEEDING ANOVULAR BLEEDING

CAUSES OF OVULAR BLEEDING Polymenorrhoea or Polymenorrhagia Causes Hyper stimulation of follicular growth by FSH Follicular growth is speeded up Shortening of follicular phase Occurs following child birth,abortion,adolescence,premenopausal period and PID

CAUSES OF OVULAR BLEEDING Oligomenorrhoea Causes Ovarian unresponsiveness to FSH Secondary to pituitary dysfunction Undue prolongation of the proliferative phase with normal secretory phase

CAUSES OF ANOVULAR BLEEDING Menorrhagia Decreased progesterone due to anovulation Endometrial growth is under estrogen Cystic glandular hyperplasia Type of abnormal bleeding Met in premenopausal women Due to disturbance in ovarian function or release of gonadotrophins

MANAGEMENT EVALUATION OF ABNORMAL UTERINE BLEEDING PROGESTERONE ESTROGEN COMBINATION DIALATATION AND CURETTAGE HYSTRECTOMY LASER ABLATION TREAT ANAEMIA